Pediatric traumatic cataracts: 10-year experience of a tertiary referral center

Abstract

Background This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. Methods Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications. Results In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures. Conclusions In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.

Eye ball deviation patterns in traumatic cataract among children in Uttar Pradesh of India

“…The severity of diminution of vision was also not much related to duration of trauma whether it was progressive or stationary. This finding was also similar to one study 11 in children with posttraumatic cataracts, where final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation and also similar to other studies. 10,12 Our study also shows that 40% of the cases show deviation in the range of 11 • -20 • (irrespective to divergence or convergence) and "Duration of trauma does not have any direct relationship with the amount of deviation because no case where duration was > 1 year" showed deviation more than 20 • while many patients where duration was less than 1 year, showed a deviation of > 20 • and this finding was also similar to other studies.…”

“…In our present study, about 3 4 of cases had progressive vision course just similar to studies. [6][7][8][9][10][11][12][13] Another interesting finding which came out from our study that about half of the cases of perforating injury showed signs of old anterior uveitis while this incidence was on 1/5 t h in cases of Blunt injury and about 1/3 of cases of traumatic cataract show signs of anterior uveitis. Our this finding was also similar to study 14 in Egypt where Twenty-one eyes sustained open globe injury (62%) with the most common cause of trauma was wooden sticks, while 13 eyes had closed globe injury (38%) with the most common cause of injury was thrown stones.…”

“…10,12 Our study also shows that 40% of the cases show deviation in the range of 11 • -20 • (irrespective to divergence or convergence) and "Duration of trauma does not have any direct relationship with the amount of deviation because no case where duration was > 1 year" showed deviation more than 20 • while many patients where duration was less than 1 year, showed a deviation of > 20 • and this finding was also similar to other studies. [6][7][8][9][10][11][12] One study 13 however found that Bow and arrow injury caused the maximum cases of traumatic cataract; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in paediatric traumatic cataracts. In our present study, about 3 4 of cases had progressive vision course just similar to studies.…”

“…10 In one study children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. 11 Despite the availability of few studies in paediatrics traumatic cataract the area of eye ball deviation patterns has largely being untouched, leading to a research gap, which was attempted to fulfill by authors in this article.…”

A neglected case of blunt eye injury leading to pediatric cataract: a lifetime consequence case report

“…On the other hand, visual acuity deterioration due to blunt trauma often occurs gradually, risking delayed proper treatment and undesirable prognosis in some children. 10 Posterior segment examination using an indirect ophthalmoscope should be performed to investigate abnormalities resulting from trauma. This can only be done if media clarity allows.…”