Management of traumatic cataract in children

To evaluate the presentation, mode of management, and clinical outcome of traumatic cataract in children.

L.V. Prasad Eye Institute, Hyderabad, India.

One hundred thirty-seven children (< 16 years) who developed traumatic cataract, seen between January 1988 and December 1993, were retrospectively analyzed. Nature of injury, type of cataract, management, and outcome were evaluated.

The study group comprised 110 boys and 27 girls. Average follow-up was 11.7 months (range 1 week to 60 months). Most injuries (54.7%) were caused by a stick or a bow and arrow. Most (53.2%) of the cataracts were total. Corneal scarring (60.5%) and iris-related problems (49.6%) were the most common associated findings. Extracapsular cataract extraction with intraocular lens (IOL) implantation was performed in 65.67% of patients. Visual acuity improved form 20/200 or worse in 97.7% of patients preoperatively to 20/60 or better in 74.1% or patients postoperatively. Seventeen patients had associated posterior segment insult; most failed to recover satisfactory vision. Posterior capsule opacification (PCO) was noted in 42.9% of patients.

Extracapsular cataract extraction with IOL implantation provides satisfactory results in children with traumatic cataract. Associated posterior segment complications and development of PCO are the major obstacles to visual rehabilitation.