Surgical intervention for traumatic cataracts in children: Epidemiology, complications, and outcomes

To describe the presentation, treatment, and outcomes of a series of patients with unilateral traumatic cataracts.

Retrospective, noncomparative review of 25 consecutive children with unilateral traumatic cataracts managed at a single institution during a 5-year period with regard to demographic data, mode of injury, clinical course, and outcome.

Paintball and BB gun injuries were the most common mode of injury, accounting for 28% of all cases, followed by injury from pens and pencils (16%). Preoperative visual acuity was poor in 19 patients (76%), and final postoperative visual acuity was poor (20/200 or worse) in 4 patients (16%); this difference was statistically significant (p < 0.001). Twenty-one percent of children with poor vision on initial examination had poor vision at their final examination, and no patients with vision better than 20/200 on initial examination developed poor vision postoperatively (p = 0.29). Patients who developed poor final vision were younger on average than those who achieved satisfactory vision (5.25 years vs 7.5 years). Poor visual outcome did not appear to depend on the time from injury to presentation and time interval between injury and cataract extraction.

Children with visually significant traumatic cataracts can have good outcomes if they are managed aggressively and appropriately. In our patient population, paintballs and BB guns accounted for more than 25% of traumatic cataract injuries, and a large number of traumatic cataracts were sustained by pens and pencils.