Factors affecting visual outcome in traumatic cataract and its associated ocular injuries - A hospital based study
Abstract
Background: Ocular trauma is a major cause of visual impairment throughout the world, although little is known about the factors that affect the visual outcome in traumatic cataract in developing countries.
Aims and Objectives: To find out the associated ocular injuries and the factors affecting final visual outcome of patients with traumatic cataract.
Material Methods: This prospective hospital based study was conducted on 40 patients of traumatic cataract. Patients were managed with lens extraction and intraocular lens implantation. Regular follow up of patients was done and best corrected visual acuity and post operative complications were assessed at the end of six months.
Results: Our study showed that majority (50%) of patients were in the age group of < 20 years with male preponderance. visual outcome was significantly better in younger age group (< 20 yrs) than the older group (> 20 yrs) ( p = 0 .03). There was no significant difference in final visual outcome of traumatic cataracts caused by penetrating or blunt trauma ( p = 0.73). Corneal tear was most common associated ocular damage followed by uveitis, lens matter in anterior chamber.
Conclusions: Age of the patient affects final visual outcome after surgical treatment of traumatic cataract but type of trauma (blunt / penetrating) had no significant effect on final visual outcome. Corneal tear was most common associated ocular damage.
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References
2. Thakker MM, Ray S. Vision limiting complications in open globe injuries. Can J Ophthalmol. 2006 Feb;41(1):86–92.
3. Kuhn F, Morris R, Witherspoon CD, Mester V. The Birmingham Eye Trauma Terminology system (BETT). J Fr Ophtalmol. 2004 Feb;27(2):206–10.
4. Bekibele CO, Fasina O. Visual outcome of traumatic cataract surgery in Ibadan, Nigeria. Niger J Clin Pract. 2008 Dec;11(4):372–5.
5. Koenig SB, Ruttum MS, Lewandowski MF, Schultz RO. Pseudophakia for traumatic cataracts in children. Ophthalmology. 1993 Aug;100(8):1218–24.
6. Mohammadpour M, Jafarinasab MR, Javadi MA. Outcomes of acute postoperative inflammation after cataract surgery. Eur J Ophthalmol. 2007 Jan-Feb;17(1):20–8.
7. Hemo Y, BenEzra D. Traumatic cataracts in young children. Correction of aphakia by intraocular lens implantation. Ophthalmic Paediatr Genet. 1987 Nov;8(3):203–7.
8. Awner S, Buckley EG, DeVaro JM, Seaber JH. Unilateral pseudophakia in children under 4 years. J Pediatr Ophthalmol Strabismus. 1996 Jul-Aug;33(4):230–6.
9. Corbett MC, Shilling JS, Holder GE. The assessment of clinical investigations: The Greenwich Grading System and its application to electro diagnostic testing in ophthalmology. Eye (Lond) 1995;9( Pt 6 Su):59-64.
10. Segev Y, Goldstein M, Lazar M, Reider-Groswasser I. CT appearance of a traumatic cataract. AJNR Am J Neuroradiol. 1995 May;16(5):1174–5.
11. McWhae JA, Crichton AC, Rinke M. Ultrasound biomicroscopy for the assessment of zonules after ocular trauma. Ophthalmology. 2003 Jul;110(7):1340–3.
12. Zhang Y, Zhang J, Shi S. Determination of posterior lens capsule status in traumatic cataract with B-Ultrasonography. Zhonghua Yan Ke Za Zhi. 1998 Jul;34(4):298–9.
13. Sethi MJ, Sethi S, Khan T, Iqbal R. Occurrence of ocular trauma in patients admitted in eye department Khyber teaching hospital Peshawar. J Med Sci. 2009;17:106–09.
14. Srivastava U, Lalramhluri R, Rawat P, Bhaisare V. Clinical evaluation of post traumatic cataract in tertiary care hospital. International Journal of Scientific & Research Publications. 2014 Oct;4(10):1–6.
15. Smith D, Wrenn K, Stack LB. The epidemiology and diagnosis of penetrating eye injuries. Acad Emerg Med. 2002 Mar;9(3):209–13.
16. Reddy AK, Ray R, Yen KG. Surgical intervention for traumatic cataracts in children: epidemiology, complications and outcomes. J AAPOS. 2009 Apr;13(2):170–79. doi: 10.1016/j.jaapos.2008.10.015.
17. Cillino S, Cassiccio A, Di Pace F, Pilliteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol. 2008 Apr;22:8–6. doi: 10.1186/1471-2415-8-6.
18. Memon MN, Narsani AK, Nizamani NB. Visual outcome of unilateral traumatic cataract. J Coll Physicians Surg Pak. 2012;22(8):497-500.
19. Synder A, Kobielska D, Omulecki W. Intraocular lens implantation in traumatic cataract. Klin Oczna 1999;101(5): 343-6.
20. Staffieri SE, Ruddle JB, Mackey DA. Rock, Paper and scissors? Traumatic pediatric cataract in Victoria 1992-2006. Clin Experiment Ophthalmol 2010 Apr;38(3):237-41. doi: 10.1111/j.1442-9071.2010.02236.
21. Gogate P, Sahasrabudhe M, Shah M, Patil S, Kulkarni A. Causes, epidemiology, and long term outcome of traumatic cataracts in children in rural India. Indian J Ophthalmol. 2012 Sep-Oct;60(5):481-6. doi: 10.4103/0301-4738.100557.
22. Shah MA, Shah SM, Shah SB, Patel CG, Patel UA. Morphology of traumatic cataract: does it play role in final visual outcome. BMJ Open 2011; 1(1):000060 doi : 10.1136./ bmjopen -2011-000060.
23. Panda A, Kumar S, Das H, Badhu BP. Striving for the perfect surgery in traumatic cataract following penetrating trauma in tertiary care hospital in Eastern Nepal. J Nepal Med Assoc. 2007Jul-Sep;46(167):119- 25.
24. Ahmed N, Aziz T, Akram S. Visual outcome after primary IOL implantation for traumatic cataract. Pak J Ophthalmol. 2011; 27(3): 152-4.
25. Kumar S, Panda A, Badhu BP, Das H. Safety of primary intraocular lens insertion in unilateral childhood traumatic cataract. J Nepal Med Assoc. 2008;47(172):179-85.
26. Sharma AK, Aslami AN, Shrivastava JP, Iqbal J. Visual Outcome of Traumatic Cataract at a Tertiary Eye Care Centre in North India: A Prospective Study. J Clin Diagn Res. 2016 Jan;10(1):05-8. doi: 10.7860/JCDR/2016/17216.7049
27. Eckstein M, Vijayalakshmi P, Killedar M, Gilbert C, Foster A. Use of intraocular lenses in children with traumatic cataract in south India. Br J Ophthalmol. 1998 Aug;82(8):911-5.
28. Sternberg P Jr, de Juan E Jr, Michels RG, Auer C. Multivariate analysis of prognostic factors in penetrating ocular injuries. Am J Ophthalmol. 1984 Oct; 98(4):467-72.
29. Shah M, Shah S, Shah S, Prasad V, Parikh A. Visual recovery and predictors of visual prognosis after managing traumatic cataracts in 555 patients. Indian J Ophthalmol. 2011 May-Jun;59(3):217- 22. doi: 10.4103/0301-4738.81043