Outcomes of Visual Acuity After Paediatric Cataract Surgery: A Systematic Review
Authors: Albaqami Fahad Mohammed , Alotaibi Muath , Alrabie Waleed Khalid , Albaqami Majed Mohammed , Almutairi Bader Saleh , Alobaylan Hamoud Abdul Mohsen , Alharthi Faisal , , Althomali Talal 
Published: August 2022

Background: In Saudi Arabia, cataract is considered the major cause of blindness as 55% of the total cases are caused by cataract. Moreover, 35.5% of visual loss is caused due to cataract making it the second leading cause of visual loss. Therefore, the aim of the study was to determine the outcome of visual acuity after paediatric cataract surgery. Methods: The preferred reporting items for systematic review and meta-analysis (PRISMA) were used in this systematic review. Cochrane handbook guidelines were used for all aspects of this study. It includes published and unpublished studies with different study designs. Such studies were found from databases including Google Scholar, Medline, PSYCHInfo, Embase Google, and Cochrane library, from their inception through the second week of March 2022 without any language restriction and identified all RCTs related to the results of visual acuity after Cataract Surgery in children. We used the following search keywords: ‘‘visual’’, ‘‘visual acuity’’, ‘‘cataract’’, ‘‘childhood blindness’’, ‘‘visual impairment’’, ‘‘amblyopia’’, ‘‘cataract surgery’’ and ‘‘pediatric cataract surgery’’ and ‘‘randomized controlled trial’’. In addition, we manually reviewed the references of a few journals to uncover more works that might be linked. Result: All RCTs connected to outcomes of visual acuity after pediatric cataract surgery were found using a total 376 articles from the electronic databases PubMed, Embase, PSYCHInfo, and the Cochrane Library, which were searched without language barriers from their inception. "Visual", "visual acuity", "cataract", "childhood blindness", "visual impairment", "amblyopia", "cataract surgery", and "pediatric cataract surgery" and "randomized controlled trial" were some of the search keywords. In addition, the references of a few journals were searched to find more potentially relevant studies. Due to redundancy, 92 articles were excluded from the total of 376. A total of 167 articles were reviewed, with 108 being rejected following a preliminary review. There were 59 full-text papers reviewed for eligibility, and 7 of them met the inclusion requirements, with all of the selected articles being of high quality. The parameters of the trials differed greatly in terms of treatment length and population investigated. Conclusion: According to the findings, most pediatric cataracts are inherited. Cataract extraction with Intraocular Lens (IOL) implantation with primary posterior capsulectomy and anterior vitrectomy (PPC+ AV) is the preferred method for pediatric cataract therapy. Active case discovery, parent counseling, and clear referral paths, are required to address cataract blindness. There may be a refractory surprise after the surgery in pediatric cataract instances, most often due to incorrect measuring, as the youngsters will be uncooperative for precise measurement or under the anesthetic influence. The surgery should be done in a fully equipped unit with qualified cooperative staff, and various techniques might be necessary to improve follow-up after the surgery. Keywords: visual acuity, cataract, childhood blindness, visual impairment, blindness