Publications by authors named "Daniel Mundia"

3 Publications

  • Page 1 of 1

Simultaneous bilateral cataract surgery with IOL implantation in children in Kenya.

J Pediatr Ophthalmol Strabismus 2012 May-Jun;49(3):139-44. Epub 2011 Aug 2.

Eye Unit, PCEA Kikuyu Hospital, Nairobi, Kenya.

Purpose: To investigate the cost implications, safety, and refractive outcomes of simultaneous bilateral cataract surgery (SBCS) with intraocular lens implantation in pediatric patients in a developing world setting.

Methods: Children aged 3 months to 10 years with bilateral congenital or developmental cataracts who underwent surgery between January 1, 2007, and December 31, 2009, were eligible for inclusion in this retrospective study. Cost data were compared for simultaneous and sequential cases. Postoperative complications and refraction data were analyzed.

Results: Ninety-six children (192 eyes) were included, 48 in the SBCS group and 48 in the sequential group. The mean age of the SBCS group and the sequential group was 3.4 and 4.7 years, respectively (P = .04). The total estimated surgical cost was $274 per child for SBCS and $344 for sequential surgery, a reduction of 20.3% for cases of SBCS. Fibrin formation of any amount occurred in 52 of 192 eyes (27.1%), 25 in the SBCS group and 27 in the sequential group (P = .75). Twenty-one eyes (10.9%) had additional surgery to remove visual axis obstruction, 14 in the SBCS group and 7 in the sequential group (P = .11). The incidence of early endophthalmitis in all cases of pediatric cataract surgery in an 11-year period was 0.16%. The incidence of anesthetic-related death during the same period was 0.11%.

Conclusion: Bilateral simultaneous pediatric cataract surgery with intraocular lens implantation may be a safe alternative to sequential surgery, with advantages in cost reduction and no difference in sight-threatening complications.
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http://dx.doi.org/10.3928/01913913-20110726-01DOI Listing
November 2013

Effect of intracameral cefuroxime on fibrinous uveitis after pediatric cataract surgery.

J Pediatr Ophthalmol Strabismus 2011 Jan-Feb;48(1):45-9. Epub 2010 Apr 22.

Eye Unit, PCEA Kikuyu Hospital, Nairobi, Kenya.

Purpose: To determine whether intracameral cefuroxime reduces postoperative fibrin formation after pediatric cataract surgery.

Methods: Children aged 3 months to 10 years with bilateral congenital or developmental cataracts who underwent surgery between February and July 2008 were eligible for inclusion in this prospective double-masked study. The same surgical technique was used in each eye. The intraocular lens was placed in either the bag or sulcus in both eyes. The same intraocular lens type was used in both eyes (polymethylmethacrylate). One eye was randomized to receive intracameral cefuroxime at the end of surgery and the fellow eye received saline. The surgeon was masked to the treatment assignment. The amount of fibrin formation in the anterior chamber of each eye was assessed by a masked grader on the fourth postoperative day.

Results: Seventy eyes of 35 children were included in the study. Fibrin formation was noted on the fourth postoperative day in 14 of 70 eyes (20%), 7 in the cefuroxime group and 7 in the saline group. The mean fibrin score was 0.57 ± 1.31 in the cefuroxime group and 0.49 ± 1.07 in the saline group. There was no statistically significant difference in the amount of fibrin formation between groups (P = .857, Wilcoxon ranked signs test).

Conclusion: Intracameral cefuroxime did not significantly reduce postoperative fibrin formation in this study. Fibrin formation does not appear to be due to bacterial contamination in most cases of pediatric cataract surgery.
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http://dx.doi.org/10.3928/01913913-20100420-03DOI Listing
September 2013
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