Abstract

Longitudinal trends on traumatic cataract wound dehiscence are scant. In this study, we present the characteristics of traumatic cataract wound dehiscence using 15 years of longitudinal trend in one of the largest medical centers in Taiwan for a period when cataract surgeries were gradually shifting from extracapsular cataract extraction (ECCE) to phacoemulsification. All patients with a prior cataract surgery who suffered from blunt open globe trauma between 2001 and 2015 at a tertiary referral center in Taiwan were included. The number of cases per year; type of prior cataract surgery; visual acuity (VA); mechanism and place of injury were analyzed. The risk factors associated with final VA were investigated in patients followed up for ≥ 1 month. Seventy-six eyes of 75 patients were included and all of them were traumatic cataract wound dehiscence with a prior ECCE (65 eyes) or phacoemulsification. The most common mechanism and place of injury was fall and at home in both cataract surgical types. The mean log of the minimal angle resolution (logMAR) of final VA was 2.15 ± 0.88 (ECCE) and 1.61 ± 0.83 (phacoemulsification) (P = .026). The most significant risk factors associated with worse final VA were retinal detachment at the initial visit and low ocular trauma score (both P < .001). Long-term visual outcome of phacoemulsification wound dehiscence was better than that of ECCE wound after a blunt trauma.

Highlights

  • Longitudinal trends on traumatic cataract wound dehiscence are scant

  • The present study investigated the outcome and longitudinal trend of traumatic cataract wound dehiscence in a tertiary referral medical center in a period when cataract surgeries were gradually shifting from extracapsular cataract extraction (ECCE) to phacoemulsification

  • We evaluated the visual outcome and risk factors associated with poor visual outcome after traumatic cataract wound dehiscence

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Summary

Introduction

Longitudinal trends on traumatic cataract wound dehiscence are scant. In this study, we present the characteristics of traumatic cataract wound dehiscence using 15 years of longitudinal trend in one of the largest medical centers in Taiwan for a period when cataract surgeries were gradually shifting from extracapsular cataract extraction (ECCE) to phacoemulsification. Phacoemulsification is performed with a small scleral tunnel or a clear corneal incision, and the incision size is approximately 5 mm with a rigid intraocular lens (IOL) implantation and ≤ 3 mm with a foldable IOL implantation Both ECCE and phacoemulsification involve creating a penetrating wound on the sclera or cornea that may act as a weak point against increased ocular pressure arising from a blunt ocular injury. The present study investigated the outcome and longitudinal trend of traumatic cataract wound dehiscence in a tertiary referral medical center in a period when cataract surgeries were gradually shifting from ECCE to phacoemulsification. To the best of our knowledge, this is the first study to demonstrate the longitudinal trend of traumatic cataract wound dehiscence and the comparison of risk factors between ECCE and phacoemulsification wound in visual outcome. Variables Initial vision NLP LP/HM 1/200 to 19/200 20/200 to 20/50 ≧20/40 Rupture Endophthalmitis Perforating injury Retinal detachment Afferent pupillary defect

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