Outcome of pediatric cataract surgery including color vision, stereopsis, and cognition in a tertiary eye care center in India.

Abstract

Background: Pediatric cataract is an important cause of avoidable childhood blindness in India. Although there are studies on clinical features and visual acuity outcomes of pediatric cataract surgery, there are no studies that look into aspects of color vision, stereopsis, and cognitive functions in children with cataracts. Studying these parameters pre- and postsurgery will help us assess the overall components of visual function that are critical for the child's development. With this in mind, we aimed to study the clinical features, outcome of treatment, color vision, stereopsis, and cognitive functions in children with cataracts.

Materials and methods: Design: Hospital-based prospective descriptive study. Data of 68 children (0 < 18 years) were collected, on the clinical features, visual acuity, color vision, stereopsis, and social and intelligence quotient before and after surgery. Data analysis was performed using Graph Pad Prism software version 9.4.0 (673).

Results: Ninety eyes of 68 children (36-bilateral/32-unilateral) were operated. A total of 46 children were available at 6 months' follow-up (28 bilateral cataracts (46 eyes) and 18 unilateral cataracts). Nineteen (67.8%) of the bilateral, had a best corrected visual acuity of 6/6-6/18 in the better eye and nine (50%) of the unilateral had a visual acuity of 6/18-6/6 in the operated eye. Preoperatively, 61.5% of the children had a stereopsis of 100-600 arc-secs. Post-operatively, 84.4% of the children had a stereopsis in the range <50-600 arc-secs. All children had color vision deficiency. Preoperatively, 62% of the children had strong and moderate deficiency, whereas postoperatively, 66.6% had mild deficiency. We found negative correlation (r = -0.503) between social quotient and percentage of visual impairment indicating that when visual impairment increases social quotient decreases. The mean IQ preoperatively was 94.36 ± 2.98 and postoperatively 101.38 ± 2.77, with 95% confidence interval P value was statistically significant (P = 0.0001). This shows better and faster performance postoperatively.

Conclusion: Majority of the children had improved visual acuity after surgery. This outcome can be extrapolated to the overall improvement in stereopsis, color vision, and higher cognitive functions.