Abstract

A 10-year-old girl, weighing 8 kg presented to our centre with recent onset diminution of vision for last 1 month. She was diagnosed with bilateral metabolic cataract with severe protein energy malnutrition and uncontrolled type 1 diabetes mellitus. Child was severely underweight and referred to us in view of a very poor general health and high risk for GA, considering bilateral cataract surgery.
Our multidisciplinary team of pediatricians, critical care, anesthesiologists embarked on the near impossible task. In nearly a month the child gained weight and there was improvement in the metabolic status and blood sugars.
Parents were counselled regarding risks of anesthesia and need for post-GA ventilatory support. We finally decided to conduct a bilateral, simultaneous, sequential cataract surgery with IOL implantation – mainly to avoid risks of double GA with such a systemic condition. The surgery was successful and child was fine with good post-op vision the next day (6/9 OU).