RESUMO
Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness worldwide. In Guatemala, a large number of premature infants are born in hospitals outside the capital city and present for evaluation at advanced stages of the disease. OBJECTIVE: To compare the cost of screening and timely treatment versus the total cost of comprehensive management of patients with visual impairment secondary to ROP. PATIENTS AND METHOD: The cost of the disease was calculated in patients who consulted due to low vision or blindness secondary to ROP. Direct costs were calculated based on those directly related to the management of the disease: medical care, rehabilitation, education, technical support, transportation, personal assistance, adaptations, and home equipment, compared with the costs of screening and timely treatment. RESULTS: The total cost of managing a child with severe visual impairment due to ROP is USD 214,666.37 and the cost of screening and timely treatment is USD 1,223.12, meaning an additional cost of USD 213,443.24 in patients who were not screened and treated on time. CONCLUSION: The cost of screening and timely treatment represents only 0.57% of the total cost of lifelong management of a child with severe visual impairment.
Assuntos
Doenças Retinianas , Criança , Lactente , Recém-Nascido , Humanos , Cegueira , Recém-Nascido Prematuro , Escolaridade , Encaminhamento e ConsultaRESUMO
The functional visual outcome after cataract surgery is influenced by several factors such as the age at diagnosis and surgical treatment, as well as visual rehabilitation. OBJECTIVE: to characterize con genital cataract patients and assess the postoperative visual outcome in an ophthalmological care center in Guatemala. PATIENTS AND METHOD: A cross-sectional retrospective study. Clinical records of all congenital cataract patients who underwent congenital cataract surgery from 2014 and 2015 were reviewed. The following was recorded: postoperative visual acuity, age at diagnosis and surgery, sex, unilateral or bilateral involvement, etiology and morphology of the cataract, preoperative poor visual prognosis factors, and postoperative follow-up. RESULTS: Fifty-nine patients underwent pediatric ca taract surgery in this period, ages ranging from 1 month to 13 years (median 48 months), and 23 were congenital (38.98%). Fourteen were male, 16 bilateral, and the mean age at diagnosis and surgery was 7 and 12 months, respectively. Only 13 patients completed 3 years of follow-up visits. Visual acuity was recorded at 3 years after surgery, observing in 11 patients and 8 patients visual impairment or worse, respectively. Delayed consultations occurred in 82.6% of the patients (older than 3 months of age). CONCLUSION: In this series, the diagnosis of congenital cataract and its surgical treatment were delayed, observing a high rate of patients unable to complete follow-up visits. The visual outcome at 3 years after congenital cataract surgery was mostly visual impairment or worse.
Assuntos
Catarata , Oftalmologia , Criança , Humanos , Masculino , Feminino , Implante de Lente Intraocular/efeitos adversos , Estudos Retrospectivos , Estudos Transversais , Resultado do Tratamento , Catarata/complicações , Catarata/diagnóstico , Catarata/congênito , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologiaRESUMO
El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.
Ocular trauma is a significant problem worldwide. The obj ective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.
