Abstract
Abstract: :
Purpose: To present a systematic approach to patients with traumatic cataract. Methods: Retrospective review on all 706 inpatient cases of severe eye injury in the Hungarian Eye Injury Registry, collected between January 1989 and December 1997. Results: A total of 308 eyes (44%) sustained lens injury; of these, 196 underwent extraction of the cataract. Of the diagnostic challenges the treating ophthalmologist faces, damage to the posterior capsule was the most difficult: while preoperatively this lesion was found in 23% of eyes, the intraoperative rate was 45%; in another 10% of eyes the determination was impossible to make even during surgery. Vitreous prolapse into the anterior chamber was present in 34% of eyes. Posterior segment injury was found in 48% of eyes; 13% of eyes had preexisting retinal detachment. Vitrectomy instrumentation was used to remove the cataract in 51% of eyes, and only 1% of eyes received an intraocular lens at the time of cataract extraction. 94% of eyes had at least 3 months of follow-up (average, 17 months). Overall, 76% of eyes had visual improvement with 37% reaching 20/40 or greater final vision. Conclusions: Our data show that traumatic cataract can present serious diagnostic and management challenges. It is recommended that unless injury to the posterior lens capsule, vitreous, and retina can definitely be excluded preoperatively, these injured eyes be managed by an ophthalmologist who is experienced in posterior segment surgical techniques.
Keywords: trauma • cataract • retinal detachment