Impact of the possible prognostic factors for visual outcomes of traumatic cataract surgery.

Abstract

This study aimed to investigate the impact of the possible prognostic factors for postsurgical success on visual acuity (VA) in traumatic cataract patients. The files of 92 patients (19 women[20.6%]-73 men[79.4%], 44 right-48 left total 92 eyes) who underwent surgery for traumatic cataracts between 2004 and 2018 were retrospectively reviewed for preoperative and final corrected distance VA(CDVA), laterality of trauma, time of admission to a hospital after trauma(TAH), type of injury, location of the injury (zone 1 [corneal], zone 2 [corneal and scleral], zone 3 [scleral]), additional ocular injury, simultaneous or secondary surgery, surgical cataract techniques, and complications. Of the 92 patients enrolled in the study, the mean CDVA was improved from preoperative 1.95 ± 0.49 logMAR to postoperative 0.73 ± 0.72 logMAR.(p < 0.001) In 36.7% of cases, the final CDVA was ≥ 20/40; it was ≥ 20/60 in 58.7%, ≥ 20/200 in 73.9%, and ≥ 20/400 in 94.5%. The strongest correlation was found between postoperative CDVA and preoperative CDVA (Pearson's R = 0.969, p = 0.0001). No correlation was found between CDVA and age, sex, and laterality. The regression analysis showed a significant relationship between the increase in CDVA and TAH, trauma type and location, and surgical timing and techniques. The worst CDVA prognosis was found for patients with a zone 3 injury; patients with a zone 1 injury had the best prognosis. The prognosis is better for a closed globe injury than an open globe injury (p = 0.019). Early TAH was related to a better prognosis than later admissions. No difference was observed between simultaneous and secondary surgeries (p = 0.413) and surgical techniques (p = 0.12). Postoperative CDVA is better in traumatic cataract patients with a better preoperative VA. Early hospital admission after trauma, closed globe, and zone 1 injuries are better prognostic factors than late hospital admission time, open globe, and zone 3 injuries.