Visual Outcomes and Complications Over 5 Years Following Lensectomy for Childhood Traumatic Cataract
Erin D Stahl1, Desirae R Sutherland2, Michael X Repka3
1Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
JAMA Ophthalmology
|November 6, 2025
Summary
Outcomes for pediatric traumatic cataract surgery show that achieving normal vision by age 5 is uncommon. Nearly half of pseudophakic eyes required surgery for visual axis opacification, highlighting the need for ongoing monitoring.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Trauma Care
Background:
- Long-term outcomes of pediatric traumatic cataract surgery are not well-documented.
- Understanding these outcomes is crucial for managing parental expectations.
Purpose of the Study:
- To evaluate visual acuity (VA) and ocular complications 5 years after lensectomy for pediatric traumatic cataract.
- To inform expectations for parents regarding surgical results and potential issues.
Main Methods:
- Prospective cohort study across 32 US and Canadian sites.
- Included 75 children (birth to <13 years) undergoing lensectomy for unilateral traumatic cataract.
- Follow-up data collected for 5 years post-surgery.
Main Results:
- Median best-corrected VA at 5 years was 20/63 in pseudophakic eyes and 20/258 in aphakic eyes.
- Age-normal VA was achieved by 21% of pseudophakic and 13% of aphakic eyes.
- 5-year cumulative incidence of surgery for visual axis opacification (VAO) was 47% in pseudophakic eyes; risk increased significantly without anterior vitrectomy.
Conclusions:
- Achieving age-normal VA was uncommon in this cohort, with only half having 5-year follow-up.
- Glaucoma prevalence was low at 5 years, but VAO required further surgery in nearly half of pseudophakic eyes.
- These findings underscore the importance of continued monitoring for children following traumatic cataract surgery.
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