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Management of traumatic cataract in children
M Krishnamachary1, V Rathi, S Gupta
1Sight Savers Cornea Training Centre, L.V. Prasad Eye Institute, Hyderabad, India.
Insights
Pediatric traumatic cataracts, often caused by blunt trauma, show good visual recovery after extracapsular cataract extraction with intraocular lens (IOL) implantation. However, posterior segment complications and posterior capsule opacification (PCO) hinder visual rehabilitation.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Traumatic cataracts in children are a significant cause of visual impairment.
- Understanding the specific injury patterns, management strategies, and outcomes is crucial for effective treatment.
Purpose of the Study:
- To evaluate the presentation, management, and clinical outcomes of traumatic cataracts in pediatric patients.
- To identify factors influencing visual recovery and potential complications.
Main Methods:
- Retrospective analysis of 137 children (<16 years) with traumatic cataracts treated between 1988 and 1993.
- Evaluation of injury nature, cataract type, surgical management, and visual acuity outcomes.
- Assessment of associated ocular findings and postoperative complications like posterior capsule opacification (PCO).
Main Results:
- Blunt trauma (stick, bow and arrow) was the most common cause (54.7%).
- Extracapsular cataract extraction with intraocular lens (IOL) implantation was performed in 65.67% of cases, improving visual acuity to ≥20/60 in 74.1%.
- Posterior segment insults and PCO (42.9%) were associated with poorer visual outcomes.
Conclusions:
- Extracapsular cataract extraction with IOL implantation is an effective treatment for pediatric traumatic cataracts.
- Associated posterior segment injuries and PCO are key challenges to achieving optimal visual rehabilitation in these patients.
Purpose:
To evaluate the presentation, mode of management, and clinical outcome of traumatic cataract in children.
Setting:
L.V. Prasad Eye Institute, Hyderabad, India.
Methods:
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.
Results:
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.
Conclusions:
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.