Background: To determine the prevalence of outpatient and hospitalization for cataract surgery in Iran. Methods: A random cluster sampling was done in a cross-sectional study on cataract surgeries performed in treatment centers of ophthalmology in Iran between 2000 and 2005. One week of each season was selected randomly and all cataract surgery files of the center were studied. This study reported the prevalence of outpatient surgery and length of hospital stay in all surgeries in Iran between 2000 and 2005. Results: Among 13, 409 studied files on cataract surgery, mean hospitalization time was 0. 79± 0. 82 days, 31. 42% of surgeries were done on an outpatient basis, and 62. 32% were hospitalized for one night. About 4. 45% and 1. 81% were hospitalized for two nights and more, respectively. Hospitalization time after surgery showed no significant difference with sex. Also, There was no significant difference between mean age of inpatients and outpatients (P=0. 08). The most common method used for surgeries was Phaco (52. 33%) and the least was lensectomy (11. 38%). Conclusions: A major proportion of cataract surgeries required hospitalization. Due to the costs of hospitalization in this surgery, the phaco method can play an important role in reducing the costs of treatment.

Several aspects of cataract surgery in children differ from adults. Ocular anatomy, cataract morphology, exaggerated response to surgical trauma, and the need for amblyopia therapy are major concerns in pediatric cataract surgery. Moreover, intraoperative differences such as location and type of incisions, management of anterior and posterior capsules and need for anterior vitrectomy are other important issues to be considered. Achieving a successful result depends on adhering to all the pre-, intra- and postoperative considerations and their proper management.

Management for pediatric cataracts should be individualized and requires experienced team work. Most cases of congenital cataracts are familial or idiopathic; only rarely are they asso-ciated with metabolic disorders or ocular ab-normalities. The time and method of treatment are of crucial importance for visual rehabilita-tion. Cataract surgery is indicated when the opacity significantly obscures the visual axis. The pediatric eye is not simply a miniaturized adult eye, surgery should be performed by an experienced surgeon and the postoperative course needs to be monitored carefully. Post-operatively, proliferation of lens epithelial cells (LECs) increases the incidence of posterior capsule opacification (PCO) and the elastic iris predisposes to iridocorneal adhesions (ICA), iris capture, pupil irregularity and intraocular lens (IOL) decenteration.

Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child, therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (<6 weeks of age, based on general neonatal health) is important for achieving the best visual outcome particularly in unilateral cases. In bilateral cases, surgery is highly recommended before appearance of strabismus or nystagmus (<10 weeks of age) with no longer than a one-week interval between the fellow eyes. Parents should be informed that surgery is a starting point and not the endpoint of treatment. Appropriate postoperative management including immediate optical correction in the form of aphakic glasses or contact lenses, or intraocular lens (IOL) implantation at the appropriate age (>1 year) is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome.Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.

Cataract surgery with intraocular lens (IOL) implantation is the most common ophthalmic surgical procedure worldwide.It is also the most common operation for correction of refractive errors, performed over five times more frequently than corneal refractive procedures. In developed countries, phacoemulsification is the predominant form of cataract surgery, accounting for more than 90% of all operations. Although a number of developments have occurred in IOL technology, the basic phacoemulsification procedure has remained largely unchanged over the past 20 years and involves a series of steps including creation of a corneal incision, capsulorrhexis and phacofragmentation.