June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Visual Outcomes and Complications over 5 years following Lensectomy for Traumatic Cataract in Children
Author Affiliations & Notes
  • Erin D Stahl
    Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Michael Repka
    Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Desirae Sutherland
    Jaeb Center for Health Research, Tampa, Florida, United States
  • Sarah R Hatt
    Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Laura B Enyedi
    Duke University Medical Center, Durham, North Carolina, United States
  • Jeffrey D Colburn
    Spokane Eye Surgery Center, Spokane, Washington, United States
  • Hawke H Yoon
    Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Raymond T Kraker
    Jaeb Center for Health Research, Tampa, Florida, United States
  • B. Michele Melia
    Jaeb Center for Health Research, Tampa, Florida, United States
  • Susan A Cotter
    Southern California College of Optometry, Fullerton, California, United States
  • Jonathan M Holmes
    University of Arizona, Tucson, Arizona, United States
  • Footnotes
    Commercial Relationships   Erin Stahl Travere, Santen, Sydnexis, Code C (Consultant/Contractor); Michael Repka Alcon-Terminated, Code C (Consultant/Contractor); Desirae Sutherland None; Sarah Hatt None; Laura Enyedi Coopervision, Novartis, Code C (Consultant/Contractor); Jeffrey Colburn None; Hawke Yoon None; Raymond Kraker None; B. Michele Melia None; Susan Cotter None; Jonathan Holmes None
  • Footnotes
    Support  NEI Grants EY011751, EY023198, and EY018810.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4402. doi:
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    • Get Citation

      Erin D Stahl, Michael Repka, Desirae Sutherland, Sarah R Hatt, Laura B Enyedi, Jeffrey D Colburn, Hawke H Yoon, Raymond T Kraker, B. Michele Melia, Susan A Cotter, Jonathan M Holmes; Visual Outcomes and Complications over 5 years following Lensectomy for Traumatic Cataract in Children. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4402.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There are few studies reporting long term outcomes following lensectomy for traumatic pediatric cataract. We report visual acuity (VA) and complication rates of strabismus, glaucoma, and other ocular conditions developing by 5 years following lensectomy for unilateral traumatic cataract.

Methods : In a pediatric cataract registry, we identified 75 children undergoing lensectomy at <13 years of age for unilateral traumatic cataract: 60 with primary intraocular lens [IOL] placement (mean age=7.5(SD=3.1) years) and 15 left aphakic (mean age=6.9(SD=4.0) years). Annual data collection from medical record review was performed through 5 years following lensectomy. We calculated median VA and proportions with age-normal VA, 5 years (range 4-6 years) after lensectomy; also, the cumulative incidence of strabismus, glaucoma, and surgery to clear the visual axis by 5 years post-lensectomy, by IOL status.

Results : Median VA was 20/63 (IQR 20/32 to 20/160) in pseudophakic eyes (n=29; mean age=7.2(SD=3.0) years) and 20/250 (IQR 20/63 to 20/800) in aphakic eyes (n=8; mean age=5.5(SD=4.3) years). Age-normal VA was achieved in 6 pseudophakic eyes (21%, 95% CI: 8% - 40%) and 1 aphakic eye (13%, 95% CI: 0% - 53%). Three pseudophakic eyes developed glaucoma with a 5-year cumulative incidence of 5% (95% CI, 0%-11%). The 5-year cumulative incidence of surgery to clear the visual axis was 48% (95% CI: 31% to 60%) in pseudophakic eyes and 13% (95% CI: 0% to 28%) in aphakic eyes, and among pseudophakic eyes was greater in those without anterior vitrectomy (86%, 95% CI: 62% - 98%) than with anterior vitrectomy (16%, 95% CI: 6% - 39%) (age-adjusted P<.0001). Of 61 participants without a history of strabismus prior to cataract surgery, the cumulative incidence of strabismus over 5 years was 45% (95% CI, 23%-60%) in those with pseudophakia (n=50) and 65% (95% CI, 12%-86%) in those with aphakia (n=11). At the last available assessment of 24 children with incident strabismus, exotropia was present in 15 (63%), esotropia in 5 (21%), and other deviations in 4 (17%).

Conclusions : Good visual outcomes were rare following lensectomy for pediatric traumatic cataract. Long-term monitoring is needed for the development of glaucoma, strabismus, and visual axis opacification requiring surgery.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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