Sana Nadeem, Ba Naeem.
Traumatic Cataract: Our Experience.
Ophthalmol Update Jan ;14(2):38-43.

Objective: To evaluate the causes, type of injury, place of injury, morphology of cataract, management, visual outcome, and post-operative complications of traumatic cataract. Design: Prospective, interventional study. Setting: Department of Ophthalmology, Fauji Foundation Hospital, Rawalpindi. Methods: This study was conducted at the Department of Ophthalmology, Fauji Foundation Hospital, Rawalpindi, from 1st November, 2012 to 31st September, 2015. All cases of traumatic cataract were included in this study, except those lost to early follow up. A detailed history, presenting visual acuity, ocular examination including complete anterior and posterior segment examination, to see other associated injuries, intraocular pressure assessment, and B-scan ultrasonography when required, were performed. Patients were treated medically or surgically as the case may be. Post-operative complications were noted. Best corrected post-operative vision was evaluated for each case. The average follow up was 11 months. Results: A total of 33 cases of traumatic cataract were studied with 25 pediatric patients. There was a male preponderance with 2:1 male to female ratio. The commonest agent of trauma was thorn in 6 (18.2%) eyes, followed by wooden stick in 4 (12.1%) and stones in 3 (9.1%). Most of the cataracts were as a result of blunt trauma in 18 (54.5%) cases, with 1 case pertaining to electric shock, and a predominant involvement of the anterior segment was seen, in 26 (78.8%) eyes. Various morphologies were encountered, with total cataract being the commonest in 22 (66.6%) eyes, followed by mixed anterior and posterior subcapsular cataract in 5 (15.2%) eyes. Associated trauma to various structures was also observed. The commonest places of injury were home and farmland. The average time lag between trauma occurrence and hospital presentation was 14.5 � 35 days. Although, 6/6 vision was achieved post-operatively in 11 (33.3%) eyes, the best corrected final visual outcome compared to pre-operative visual acuity was not found to be statistically significant (p=0.208). This can be attributed to various factors. All cases were managed surgically; with Intraocular lens (IOL) implantation either primarily or at a later stage in eyes with good visual potential, the pre-existing inflammation being controlled medically. Posterior capsular opacification was the most common complication in 29 (87.8%) eyes, followed by fibrinous uveitis and glaucoma in 10 (30.3%) eyes each. Conclusion: Surgical management of traumatic cataracts if done with complete pre-operative evaluation, a careful surgical approach, and a good post-operative management, is a safe and effective means of vision restoration. Visual outcome is limited by associated ocular structural damage.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com