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Edson Ichihara, Serena X. Wang, David R. Weakley; Surgery for Traumatic Pediatric Cataracts: Epidemiology And Outcomes. Children’s Medical Center of Dallas 2006-2009. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6223.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the treatment and visual outcomes of 42 pediatric patients with traumatic cataracts.
An IRB approved retrospective chart review of patients who underwent cataract surgery following ocular trauma, between 2006 and 2009 at the Children's Medical Center of Dallas. Data collected included gender, mechanism of injury, age at injury, age at surgery, surgical complications, refractive rehabilitation and visual outcome.
A total of 42 children with unilateral traumatic cataract were operated between 2006 and 2009. Mean age was 7.25 years (SD = 4.10, range 1.3-15.9), 34 patients (81%) were male. BB gun injuries were most common (17%), followed by knives, sticks, animals (10% each) and varied other causes. The presenting visual acuity was 20/200 or worse in 33 eyes (79%) with measurable acuity. Twenty five patients (60%) had penetrating injuries requiring primary repair and 17 (40%) were blunt injuries. Thirty five patients (83%) had a primary IOL implantation, 1 (2%) patient a secondary IOL and 6 (15%) left aphakic. Visual acuity at the most recent follow-up was 20/40 or better in 20 patients (48%), 20/50 to 20/150 in 8 patients (19%) and 20/200 or worse in 13 patients (31%). One patient was lost to follow up.Visual outcome in the 17 non-penetrating injury patients was ≥ 20/40 in twelve patients (70%) and ≤ 20/200 in 5 patients (30%). Among the 25 patients with penetrating injuries, final visual acuity was ≥ 20/40 in 8 patients (32%), 20/50 to 20/150 in 8 patients (32%) and ≤ 20/200 in 8 patients (32%).Of the patients with primary IOL implantation, 11 (31%) required YAG laser capsulotomy and 2 (6%) surgical secondary membrane removal. Eleven patients (26%) developed amblyopia, 9 (21%) required muscle surgery. Two eyes (5%) were enucleated.
Appropriate surgical intervention in traumatic pediatric cataracts improves outcome though significant visual loss is common. Patients with cataracts from penetrating injuries fare worse than those with blunt injuries. IOLs can be implanted safely in the majority of these patients.
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