Surgical Management and Evolution of Traumatic Cataracts in Children

Abstract

Purpose: : Traumatic cataract is a major complication of ocular trauma in children. The aim of the present study was to describe the surgical management and outcomes in pediatric traumatic cataracts.

Methods: : Children operated for traumatic cataract between 2000 and 2008 were retrospectively studied. Data collected included age and type of trauma, delay between trauma and cataract extraction, surgical procedure, complications, anatomic and visual outcomes.

Results: : A total of 24 children were operated for traumatic cataract between 2000 and 2008, sex ratio (F/M) was 0.50 and mean age at the time of the trauma was 4.9 years. Half of traumatic cataracts were secondary to blunt trauma and half to perforating injuries. Initial visual acuity was inferior to counting fingers in 5 children with blunt trauma and in 8 children with perforating injury. The most frequent associated lesions were hyphema, iris dialysis, intravitreous hemorrhage and posterior segment lesions. After cataract extraction associated with anterior vitrectomy and IOL implantation in most cases, final visual acuity in blunt trauma was for ≥ 20/25 for 3 patients and ≤ 20/60 for 7 children. In case of perforating injury, final visual acuity was ≥ 20/40 for 2 patients and ≤ 20/60 for 9 children.

Conclusions: : Traumatic cataracts in children are caused by various mechanisms. They need an urgent surgical management . Visual prognosis remains poor because of associated complications and amblyopia .

Keywords: cataract • trauma • amblyopia