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Comparison of anesthesia options for pediatric cataract surgery in a rural setting

Poster Details

First Author: M.Diab SAUDI ARABIA

Co Author(s):    H. Maher              

Abstract Details

Purpose:

Cataract surgery is the most commonly performed intraocular surgery in the children population. It is routinely performed under general anesthesia alone or with a local anesthetic. Under certain conditions, as in rural environments or in developing countries, the facilities for general anesthesia and peri-operative care are in limited availability and related to increased morbidity. The purpose of this study was to compare the outcomes of pediatric patients undergoing cataract extraction surgery under local or general anesthesia.

Setting:

Magrabi Hospital Asser ,faculty of medicine Ain Shams Univiersty, Cairo, Egypt

Methods:

This is a retrospective study performed in rural southern Ethiopia during July 2007- August 2008. Patients younger than 15 years diagnosed as suffering from pediatric cataract underwent a clinical examination followed by cataract surgery. Clinical indices including visual acuity and ocular complications were noted following surgery. Visual acuity results obtained from patients of all ages were separated into ambulatory or non-ambulatory categories. Exclusion criteria for local anesthesia included: age under 7 and perforating traumatic cataract.

Results:

Ninety-one eyes of 73 consecutive patients (57 male,16 female). The average age at diagnosis was 7.1±0.5 years. Fifty-five operations were performed under general anesthesia and 36 with a local anesthetic. Patients that had operations under local anesthesia were older than those performed with general anesthesia (10.14±0.56 vs.4.87±0.49 years, p<0.0001). Rural children withstood local anesthesia better than urban kids. local anesthesia was delivered successfully surgical compliance was good. No significant differences between the groups were noted regarding visual acuity results or complications. Children older than 7 are suitable for cataract surgery under local anesthesia in this setting.

Conclusions:

Discussion: Our results show that pediatric patients that underwent local anesthesia for cataract extraction surgery had similar results as patients who were operated under general anesthesia. Patients in both groups withstood the operation well and showed marked improvement during the post-operative follow-up period. Though, in both groups several cases of postoperative complications were noted, no significant difference was noted among the groups. Likewise, all patients showed marked improvement in visual acuity following the operation with a similar improvement rate between the groups. Conclusion: Local anesthesia should be considered a valid option for operating older children, especially under limited medical settings.

Financial Disclosure:

NONE

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