Surgical and visual outcomes in traumatic cataract following phacoemulsification, in a mexican pediatric population.

Abstract

Purpose: Report the number of pediatric patients with traumatic cataracts, attending a reference center in Mexico City, to analyze different epidemiologic characteristics, and their surgical and visual outcomes.

Methods: Retrospective, observational case series study was performed. We reviewed clinical data from January 1^st 2013, to December 1^st 2014. Clinical electronic records were reviewed of patients with diagnosis of Traumatic Cataract, with ages from 0 to 17 years and 364 days. Patient record had to comply with this diagnostic: history of trauma to the eye, with development of cataract, and further surgical intervention, with a minimum of 1 year of follow up.<br /> Information from clinical records: gender, age, medical history, type of trauma, residence, time between trauma and surgery, visual acuity in all visits, findings in exploration, axial length, type of surgery and complications, final refraction, capsular bag opacification, need of referral to other Departments.

Results: We analyzed 22 patients. Average age was 9.55 ± 4.16 years. Six female (27.3%) and 16 males (72.7%). 1 patient (4.6%) had history of previous disease. 6 patients (27.3%) had open-globe penetrating injury, and 16 patients (72.8%) had closed-globe blunt trauma. 8 patients (36.3%) lived in the city, while 14 (63.7%) lived in rural communities. Time between trauma and surgery: average of 3.99 ± 7.43 months. Visual acuity in first visit: 5 patients (22.8%) with light perception, 10 (45.5%) with hand movement, 5 (22.8%) with an average of 1.78 ± 0.83 logMAR. At one-year follow up, 1 (4.6%) patient had no light perception; two (9.1%) hand movement. The rest, average of 0.35 ± 0.43 logMAR. Axial length average: 22,86 ± 1.09mm. All patients underwent phacoemulsification, in 21 (95.6%) surgeon was able to place an IOL, and 1 patient (4.6%) was left in aphakia. Capsular bag opacification developed in 4 patients (18.2%). In 20 (91%) the final refraction was obtained, with a mean spherical equivalent of -0.41 ± 0.84 D. 6 patients (27.3%) had to be referred to another Department.

Conclusions: Traumatic cataract had higher prevalence in male children, with predominant blunt trauma, from rural communities. Most achieved vision at 1 year follow up better than 0.35 logMAR.<br /> This shows us better ways to understand the approach to traumatic cataracts in children, with an ultimate goal to give better quality of life.