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Pediatric traumatic cataracts: 10-year experience of a tertiary referral center
Nesrin Tutaş Günaydın1, Ayşe Yeşim Aydın Oral2
1Department of Ophthalmology, University of Health Sciences, Dr. Lütfi Kırdar Kartal City Hospital, Denizer Cad. No:1, 34865, Cevizli, 34100, İstanbul, Turkey. drnesrintutas@hotmail.com.
Insights
Posterior capsulotomy and anterior vitrectomy significantly improve visual acuity in pediatric traumatic cataracts. These procedures, combined with lens aspiration, offer better outcomes, but require further study for confirmation.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Trauma Care
Background:
- Pediatric traumatic cataracts are a significant cause of visual impairment in children.
- Understanding factors affecting visual outcomes is crucial for effective management.
Purpose of the Study:
- To evaluate factors influencing final visual acuity in pediatric patients with traumatic cataracts.
- To identify surgical interventions that optimize visual outcomes after trauma-induced cataracts.
Main Methods:
- Retrospective review of pediatric patients (<16 years) with traumatic cataracts.
- Analysis of demographic data, trauma characteristics, surgical details, and visual acuity outcomes.
- Comparison of final best-corrected visual acuity (BCVA) based on surgical procedures, including posterior capsulotomy and anterior vitrectomy.
Main Results:
- Posterior capsulotomy (PC) and anterior vitrectomy (AV) performed during cataract surgery were associated with significantly better final visual acuity.
- Primary intraocular lens (IOL) implantation was performed in 70.9% of eyes.
- Final BCVA improved from 5.9% to 69.1% after treatment in measurable eyes.
Conclusions:
- Final visual acuity in pediatric traumatic cataracts is not influenced by patient demographics or trauma characteristics.
- Combined posterior capsulotomy and anterior vitrectomy with lens aspiration significantly improve final BCVA.
- Prospective studies are needed to confirm the efficacy of this combined approach for amblyopia treatment.
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.
