The Gender Issue in Congenital and Developmental Cataract Surgery

Purpose To describe the demographic pattern of congenital cataract surgery at a referral ophthalmology center in Iran and to evaluate any possible difference between the genders. Methods Subjects aged 15 years or less scheduled for cataract surgery were enrolled in this cross-sectional study. Data was retrieved from the electronic medical records according to the ICD-10 coding system. Age and proportion of operations by sex were the main parameters of interest. We employed analysis of covariance to compare age at surgery and logistic regression to obtain the trend for the number of cataract procedures in boys and girls. Results Overall, 314 congenital cataract procedures were performed during the study period, 55 (17.5%) of which were related to second eye surgery. Operated eyes belonged to male subjects in 172 (54.8%) cases and female subjects in 142 (45.2%) cases. Mean age at operation for both first and second eyes was 3.2±3.0 years overall, and 3.1±2.9 versus 3.4±3.0 years in girls and boys, respectively (P= 0.62). Surgery was performed before one year of age in 33.2% and before 5 years in 75% of cases. Among patients undergoing second eye surgery, girls presented significantly later than boys (at 4.2±3.3 vs. 2.6±1.7 years, P= 0.012). Conclusion The rate of congenital/infantile cataract surgery in boys was almost 10% higher than girls. We observed a significant difference only regarding age at second eye surgery which comprised 17.5% of all operations. One third and two thirds of the procedures were performed under the age of one and five years, respectively.

[1]  S. Krishnaiah,et al.  A survey of severe visual impairment in children attending schools for the blind in a coastal district of Andhra Pradesh in South India , 2012, Eye.

[2]  H. Ahmadieh,et al.  Rapid assessment of avoidable blindness in Iran. , 2011, Ophthalmology.

[3]  H. Nkumbe,et al.  Meeting the need for childhood cataract surgical services in Madagascar. , 2011, African journal of paediatric surgery : AJPS.

[4]  C. Gilbert,et al.  Childhood blindness and severe visual impairment in Malaysia: a nationwide study , 2011, Eye.

[5]  R. Khandekar,et al.  Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study – 2005) , 2010, Indian journal of ophthalmology.

[6]  P. Courtright,et al.  Child Eye Health Tertiary Facilities in Africa. , 2010, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[7]  P. Courtright,et al.  Blindness in Childhood in Developing Countries: Time for a Reassessment? , 2009, PLoS medicine.

[8]  S. Lewallen,et al.  Cataract in children attending schools for the blind and resource centers in eastern Africa. , 2009, Ophthalmology.

[9]  K. Mohammad,et al.  The Prevalence of Lens Opacities in Tehran: The Tehran Eye Study , 2009, Ophthalmic epidemiology.

[10]  S. Lewallen,et al.  Measuring cataract surgical services in children: an example from Tanzania , 2008, British Journal of Ophthalmology.

[11]  Kuk-Hyoe Kim,et al.  Clinical Outcomes of Surgical Techniques in Congenital Cataracts , 2008, Korean journal of ophthalmology : KJO.

[12]  R. Geneau,et al.  Why are Children Brought Late for Cataract Surgery? Qualitative Findings from Tanzania , 2008, Ophthalmic epidemiology.

[13]  R. Geneau,et al.  Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania , 2005, British Journal of Ophthalmology.

[14]  M. Mohammadpour,et al.  Causes of severe visual impairment and blindness in schools for visually handicapped children in Iran , 2005, British Journal of Ophthalmology.

[15]  H. Fledelius,et al.  A nationwide Danish study of 1027 cases of congenital/infantile cataracts: etiological and clinical classifications. , 2004, Ophthalmology.

[16]  S. Ruit,et al.  Pediatric cataract surgery in Nepal , 2004, Journal of cataract and refractive surgery.

[17]  H. Fledelius,et al.  Incidence and cumulative risk of childhood cataract in a cohort of 2.6 million Danish children. , 2004, Investigative ophthalmology & visual science.

[18]  Serge Resnikoff,et al.  VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. , 2004, Archives of ophthalmology.

[19]  J. Rahi,et al.  Measuring and interpreting the incidence of congenital ocular anomalies: lessons from a national study of congenital cataract in the UK. , 2001, Investigative ophthalmology & visual science.

[20]  Allen Foster,et al.  Results of cataract surgery in young children in east Africa , 2001, The British journal of ophthalmology.

[21]  S. Lewallen,et al.  Gender and blindness: a meta-analysis of population-based prevalence surveys , 2001, Ophthalmic epidemiology.

[22]  X. Liang,et al.  Causes of childhood blindness in the People’s Republic of China: results from 1131 blind school students in 18 provinces , 1999, The British journal of ophthalmology.

[23]  Lixin Xie,et al.  Visual impairment and delay in presentation for surgery in chinese pediatric patients with cataract. , 2011, Ophthalmology.

[24]  D. Vanderveen,et al.  Infantile Cataracts , 2008, International ophthalmology clinics.

[25]  R. Khandekar,et al.  Pediatric cataract and surgery outcomes in Central India: a hospital based study. , 2007, Indian journal of medical sciences.

[26]  S. C. Reddy,et al.  Causes of childhood blindness in Malaysia: results from a national study of blind school students , 2004, International Ophthalmology.

[27]  C. Gilbert,et al.  Childhood blindness in the context of VISION 2020--the right to sight. , 2001, Bulletin of the World Health Organization.

[28]  J. Rahi,et al.  Epidemiology of cataract in childhood: A global perspective , 1997, Journal of cataract and refractive surgery.