Aphakic Optical Correction with Intraocular Lenses for Children with Traumatic Cataracts

Abstract

Two hundred and thirty-eight children, all but one with unilateral traumatic cataracts, were treated by our paediatric ophthalmology group between 1974 and 1988. One hundred and seventeen patients received IOLs, 86 received contact lenses, three received glasses, 14 had epikeratoplasties and 18 patients received no correction because of the marked reduction in vision following the initial trauma. Three designs of IOLs were implanted: 79 iris suture IOLs between 1974 and 1981, followed by 28 anterior chamber and 20 posterior chamber IOLs implemented between 1981 and 1988. The incidence of preoperative complications was 59%. Secondary operations were somewhat more frequent for IOL-containing eyes at 51%, but less than epikeratoplasty eyes at 79% and more than contact lens or glasses rehabilitated eyes at 41 and 33% respectively. Iris-supported IOLs required more secondary surgery, but these were often related to the occurrence of secondary membranes which were routinely opened at a second operation. The visual results were equal for patients receiving contact lens and IOLs even with a skewed case selection. Patients receiving primary IOLs had a better visual result than those patients receiving secondary IOLs because of time lost before the IOL was implanted and before amblyopia therapy was begun. Children over 8 years at the time of injury also achieved far better visual results because of the presence of visual maturity.