Introduction: Paediatric cataract is a major cause of preventable childhood visual impairment, with surgical outcomes associated with several factors. This study aimed to investigate the post-operative visual outcomes, complications, and factors associated with poor visual outcomes in paediatric patients who underwent cataract surgery, one-year post-operation.
Materials and methods: Retrospective study on paediatric patients who underwent cataract surgery in Hospital Raja Perempuan Zainab II, Malaysia from January 2014 until December 2023. The data was collected from medical records.
Results: 48 paediatric patients (65 eyes) were recruited. The mean age was 7.7 ±4.79 years. 32 (66.7%) males and 16 (33.3%) females. 17 patients had bilateral while 31 patients had unilateral cataract. 44 eyes (67.7%) had primary cataract, and 21 eyes (32.3%) had secondary cataract. Overall, 53.8% (35 eyes) achieved good visual outcomes of 6/12 or better, but outcome was better in primary cataracts with 56.8% achieved good vision compared to 47.6% in secondary cataracts. 52.4% (11 eyes) of the secondary cataracts was traumatic in nature, with male predominance (72.7%) and 72.7% (8 eyes) achieved good vision. Postoperative complication occurred in 18.5% (12 eyes), with posterior capsular opacification being the commonest. Overall, ocular and systemic comorbidities contributed to poor visual outcome. Specifically for traumatic cataracts, the factors leading to poor visual outcomes were significant corneal opacity and amblyopia. Implantation of posterior chamber IOL was significantly associated with good visual outcomes (60.7%).
Conclusion: Paediatric cataract surgery outcomes at our centre are comparable with previous studies, with posterior chamber IOL implantation give favourable results. Ocular and systemic comorbidities significantly elevate the risk of poor outcomes. Corneal scarring and amblyopia were common causes of poor vision in traumatic cataracts.