Cases Of Traumatic Cataract Research Articles

Clinical and demographic profile of pediatric cataracts among Omani children presenting to a tertiary eye care center, Oman.

This study aimed to know the clinical and demographic profile of pediatric cataracts in Oman. The aim of this study was to describe the demographic and clinical profile of pediatric cataracts in a tertiary care hospital, Oman. This was a hospital-based, retrospective observational study. A retrospective cross-sectional study of all Omani children presented to ophthalmology outpatient at a tertiary hospital, between January 2012 and December 2016. All patients aged <18 years presented with lens opacity were included in the study. Traumatic cataract cases were excluded from the study. SPSS version 22.0 International Business Machines, (Armonk, New York, Unites States of America, dated 8/13/13) used for statistical analysis. Among 379 eyes of 239 patients, 58.6% (140 patients) had bilateral cataracts. Male-to-female ratio was 1.38:1. We arrived at prevalence of 4.32 with 95% confidence interval (3.85, 4.77) of congenital cataract cases/10,000 Omani Children. Most patients (54%) were from either Muscat (28.9%) or A'Sharqiyah (25.1%). The median age of cataracts first noticed by parents was 3 months and the median age of presentation to the eye care unit was 15 months. Patients with positive family history significantly (P = 0.007) presented with bilateral cataracts (75%). About 22.2% of the patients had associated systemic diseases. Among those with systemic association, 77.4% of cases had bilateral cataracts. About 35.4% of eyes had another ocular association. The most common ocular association was squint (11.1%). The most common cataract morphologies at presentation were 20.1% presenting with total lens opacities and 19.8% with posterior subcapsular/posterior lenticonus. A higher demographic distribution of pediatric cataracts was found in Muscat governorate. There was a significant median delay in presentation to the pediatric ophthalmology clinic by 12 months since lens opacity was first noticed by parents.

Clinical Outcomes of Management of Traumatic Cataract in a Tertiary Care Centre

Background and Objectives : Ocular trauma can lead to development of cataract when natural lens is damaged by either blunt or penetrating injury. The management of traumatic cataract follows the same principle as for senile cataract but associated damage to ocular tissues and several post-operative complications may lead to suboptimal visual outcome. This study was conceptualized to evaluate the visual outcomes following management of traumatic cataracts. Material and Methods : This prospective, longitudinal study was conducted on 80 patients with traumatic cataract in tertiary care centre. Patients were managed surgically and were followed up for a period of six months. Visual acuity was measured at every follow-up visit and any post-operative complications were noted and managed, accordingly. Final visual acuity was assessed at the end of six months. Results: Maximum cases of traumatic cataract (53.75%) were observed in age group of &lt;20 years with male to female ratio of 2.63:1. Maximum patients (92.15%) were implanted posterior chamber intraocular lens, either as a primary or secondary procedure. Uveitis and posterior capsular opacification were most common post-operative complications (30%) and 68.75% cases achieved a final visual acuity of 6/6-6/ 18 at the end of six months. Conclusions Traumatic cataract is an important cause of ocular morbidity specially in young patients. Surgery in cases of traumatic cataract can yield good visual outcomes if posterior segment is not involved and if post-operative complications are managed efficiently.

A prospective clinical evaluation and management of traumatic cataract

Aim: The aim was to present the experience in the management of cases of traumatic cataract with special reference to age, sex, type of injury, preoperative status of the eye, associated ocular injury, timing of injury and its effect on the final visual outcome. Design: Prospective study. Statistical Analysis: Non-parametric method (Mann whitney U test).

Study of different mode of traumatic catarach and its visual outcome after surgery

Ocular trauma being common reason for visual morbidity. This study helps to know the different mode of traumatic cataract and their visual outcome. A hospital based prospective study done in Department of ophthalmology of a medical college 30 cases of traumatic cataract excluding complicated cataract, congenital cataract etc. underwent detailed history and local examination with investigations. Data was analysed with regard to relationship between mode of trauma and final visual outcome achieved with surgical technique. Patients were followed-up at 1 week, 1 and 6 months and visual acuity was recorded. A 56.6 % sustained penetrating trauma while 43.2% got blunt trauma. In blunt trauma postoperative cases BCVA was 6/18-6/12 and penetrating trauma cases 6/60-6/18. A 35.2% patients had corneal opacity among penetrating injury which was most common cause for reduced visual acuity. This study provides data of different mode of Traumatic cataract and visual outcome depends on the type of injury and its presentation.

Visual outcome of traumatic cataract at a tertiary eye care center

Background: Traumatic cataracts account for a large proportion of visual disability and blindness in the general population, especially in developing countries. It is associated with various ocular injuries. Aim and Objective: The aim of the study was to evaluate the visual outcome of patients with traumatic cataracts. Material and methods: A prospective study was done in the Department of Ophthalmology in Netaji Subhash Chandra Bose Medical College, Jabalpur (Madhya Pradesh). Materials and Methods: A total of 124 patients diagnosed as a case of traumatic cataract were subjected to a detailed history, systemic, and local examination with relevant investigations. Medical or surgical managements were done accordingly. Patients were subsequently followed up. Results: About 53.22% of patients sustained penetrating trauma while 41.93% got the blunt injury and 4.83% perforating injury. Out of total, 79.03% of patients were males, while 20.96% were females. The most common cause of blunt trauma was wooden stick (53.84%), whereas iron wire (31.81% patients) was the most common cause of penetrating injury. About 25% of patients had corneal opacity as associated ocular morbidity. About 54.83% of patients adopted small-incision cataract surgery with posterior chamber intraocular lens (IOL) procedure for traumatic cataract surgery. About 39.51% of patients had attained final best-corrected visual acuity (VA) of 6/9–6/18, and 32.25% patients of 6/24–6/60, while 28.22% of patients had vision

Visual outcome of management in traumatic cataract cases: A cross sectional study at tertiary care hospital

Visual outcome of management in traumatic cataract cases: A cross sectional study at tertiary care hospital

Surgical approach to pediatric traumatic cataract

Purpose: The aim of this study was o evaluate our surgical approach in children who were operated due to traumatic cataract in our clinic.Material and Methods: By using anterior vitrector, lensectomy was performed in pediatric patients who have traumatic cataract. The patients who have capsular support, the intraocular lens (IOL) was implanted in the capsular bag or in the sulcus and who do not have capsule support the IOL was implanted with sutureless intrascleral fixation method.Results: 21 eyes of 21 patients were included in the study. The mean age of the cases was 8.7 ±3.5 years. All of the cases had penetran injuries, and performed corneal suturation before due to the corneal perforation. Lensectomy was performed by using anterior vitrectomy probe in all patients. ln two patients, monoblock foldable IOL were implanted in the capsular bag, in 12 patients three-piece foldable IOL were implanted in the sulcus and in 4 patients three-piece foldable lens were implanted with intrascleral fixation. The combination of pars plana vitrectomy-lensectomy and three-piece foldable IOL implantation with intrascleral fixation were done in three patients because of retinal problem. Scleral tunnel was preferred to corneal tunnel for implantation of IOL.Conclusion: Lens capsule integrity was usually impaired in traumatic cataract cases. It may be not possible to do capsulorrhexis in these cases. Vitreous and fibrotic membrane are usually found in anterior chamber in these cases. It is considered that it is more appropriate to do lensectomy by using anterior vitrectomy probe instead of standard cataract surgery.

Airsoft gun-related ocular injuries: long-term follow-up

To describe the long-term ocular effects of airsoft gun pellet injuries. The present study extends by 7-10years the results of a 2010 study on the acute ocular findings related to airsoft gun pellet injuries in 59 patients, wherein we found a variety of anterior and posterior segment injuries, including hyphema (66%), corneal edema (61%), corneal erosions (59%), and traumatic mydriasis (25%), as well as retinal edema in (22%), retinal hemorrhages and mild vitreous hemorrhage in (2.1%), and, in 1 patient, elevated intraocular pressure and traumatic cataract. Of the 59 patients in the original study, up-to-date medical records were available for 26 (44%; 20 males). The mean follow-up time was 8years (range, 7.2-10.3years); the mean age, 17.1years. Persistent abnormal findings included traumatic cataract in 3 cases (11.5%) and iris dialysis in 1 case (3.8%). In all traumatic cataract cases, cataract was not present at the time of initial examination after injury. Final mean best-corrected visual acuity was 0.92 (range 0.67-1.0), logMAR 0.03 (range 0.18-0). While most acute airsoft gun-related ocular injuries are transient, some patients may develop significant and potentially sight-threatening ocular damage, even in the absence of significant pathologic findings at the time of the injury. Long-term follow-up on these patients is advisable.

Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study

Traumatic cataract is a main cause of visual impairment in pediatric populations and is preventable. Awareness of the causes and consequences of pediatric eye trauma play roles in health education and prevention of blindness. We conducted a retrospective chart review based on 5-year clinical data of pediatric traumatic cataract cases treated at the Eye and Ear, Nose and Throat Hospital of Fudan University, Shanghai, China. Clinical features including demographic data, injury mechanism, and causative agents were analyzed. A total of 321 eyes of 321 children (male, 74.1%) were included. Penetrating injury accounted for 76.6% of all injuries; 65% of children with such injuries underwent their first surgery on the day of injury. The average age at injury was 6.3 ± 3.7 years, while the peak age was from two to eight years. The main causes of ocular injury were sharp metal objects, toys, and wooden sticks. The causative agent changed with increasing age; however, scissors were the leading cause within almost all age groups. Cataract surgery significantly improved visual acuity in children with traumatic cataract. These findings add information regarding the characterization of pediatric traumatic cataract in China and can help guide safety education and preventative measures.

Study of The Spectrum of Traumatic Cataract Cases in A Tertiary Eye Hospital

Study of The Spectrum of Traumatic Cataract Cases in A Tertiary Eye Hospital

Clinical analysis of eyeball perforating injury complicated with intraocular foreign body caused by gun-shotting nail

Objective To analyse clinical characteristics and prognosis of eyeball perforating injury with intraocular foreign body caused by gun-shotting nail in construction decoration. Methods The clinical data of 12 eyes of 12 cases with eyeball perforating injury complicated with intraocular foreign body caused by gun-shotting from January 2011 to October 2015 were analyzed retrospectively. Results Two cases of corneal rupture, 10 cases of scleral rupture , 8 cases of traumatic cataract, 11 cases of vitreous hemorrhage and 8 cases of retinal detachment were occurred.The postoperative visual acuities were increased compared with preoperative ones after positive operation. Conclusion To understand clinical characteristics of eyeball perforating injury complicated with intraocular foreign body caused by that gun-shotting nail and correct treatment can decrease the proportion of permanent visual loss. Key words: Gun-shotting nail; Perforating injury; Eyeball; Intraocular foreign body; Treatment; Efficency

Iris-claw versus posterior chamber fixation intraocular lens implantation in pediatric traumatic cataract

AimThis study aims to compare visual outcomes and complications of iris-fixated (claw) intraocular lens (IFIOL) implantation with those of posterior chamber intraocular lens (PCIOL) implantation in children with traumatic cataract. Settings and designRetrospective observational clinical audit. Materials and methodsA total of 50 pediatric traumatic cataract cases that underwent lens removal and IOL implantation (IFIOL or PCIOL) with or without corneal or corneoscleral tear repair between January 2009 and December 2013 were analyzed. After meeting the eligibility criteria, their pre- and postoperative visual outcomes and complication rates were recorded. Data were analyzed descriptively. ResultsOut of 50 children, IFIOL and PCIOL implantations were performed in one eye of each of 25 children. Their mean age was 11 ± 4 years (range 4–18 years). Primary (cataract removal with lens implantation) and secondary (corneal tear repair followed by cataract removal with lens implantation) procedures were performed in 19 (76%) and six (24%) children in the IFIOL group and in 21 (84%) and four (16%) children in the PCIOL group, respectively. There was an improvement in best corrected visual acuity postimplantation in both the IFIOL and the PCIOL group, and no significant difference in the logarithm of the minimum angle of resolution of best corrected visual acuity was observed between the two groups over 36 months. Only three eyes in the IFIOL group developed complications: one eye developed secondary glaucoma, one disenclavation of IOL haptic, and one cystoid macular edema. ConclusionBoth IFIOL and PCIOL implantations have good visual outcomes and minimal postoperative complications; therefore, IFIOL can be used as an alternative to PCIOL in children with traumatic cataract with inadequate capsular support.

Visual Outcome of Traumatic Cataract at a Tertiary Eye Care Centre in North India: A Prospective Study.

One of the most common presentations of blunt and penetrating ocular trauma is traumatic cataract. It remains a significant cause of visual impairment and physical disability among adults and children. It is associated with various ocular injuries. To evaluate the associated ocular injuries and final outcome of patients with traumatic cataract along with their demographic features and modes of trauma. A prospective study done in Department of Ophthalmology in M.L.B. Medical college, Jhansi from February 2010 to July 2011. A total of 48 patients diagnosed as a case of traumatic cataract were subjected to a detailed history, systemic and local examination with relevant investigations. Medical or surgical managements were done accordingly. Patients were subsequently followed-up and visual acuity was recorded. Appropriate statistical tests were applied. A 54.2% patients sustained penetrating trauma while 45.8% got blunt injury. Out of total, 79% patients were males while 50% were less than 15 years of age. Causative agents were stone, wood items, stick, metal objects etc. Among blunt trauma cases, 64% of the patients had visual acuity <6/60 while among penetrating trauma cases nobody had acuity >6/18. Anterior segment was more involved as compared to posterior segment. A 38.5% patients had corneal opacity among penetrating injury patients. The interval between trauma and surgery was less than one month among 75% of patients. After three months of surgery, 43.7% patients had visual acuity of >6/18. This study provides recent data of patients hospitalized after ocular trauma and diagnosed as a case of traumatic cataract. Traumatic cataract occurs mostly in younger males. Surgical intervention is necessary to improve visual outcome. Good visual outcome was obtained in nearly half of the patients. Traumatic cataract patients can have good visual outcome depending upon proper management.

Target region sequencing in sporadic congenital cataracts reveals a new genotype‐phenotype relation for the GALK1 gene

PurposeThe purpose of this study was to investigate the genetic effects underlying sporadic congenital cataracts (SCC).MethodsWe collected DNA samples from 74 SCC patients and 20 traumatic cataract (TC) patients in the same age group as normal controls and performed genomic sequencing of 61 cataract‐related genes (including introns, exons and 10 bases from the 3′ and 5′ ends) by target region capture and next generation sequencing. We chose previously reported cataract‐related genes and also included other lens disease‐related genes, including microphthalmia (SOX2, PAX6, OTX2, RAX, FOXE3 and CRYBA4); aniridia (FOXC1, PITX2 and PITX3); Marfan syndrome (FBN1); ectopia lentis (ADAMTSL4 and ADAMTS17) and Alport syndrome (COL4A5).ResultsBy filtering the SNPs that were previously deposited in the NCBI SNP database (dbSNP) or were associated with TC cases, we identified 72 novel variants in 40 genes from 49 patients. The mutation frequency of the GALK1 gene was much higher than the other tested genes, with mutations detected 10 times in 7 patients; followed by CRYBB3 and FBN1 the mutation of which were detected 4 times. Moreover, we observed a posterior polar‐cataract phenotype in 86% (6 out of 7) of SCC patients with mutations in GALK1.ConclusionsWe conclude that genetic mutations could be important contributing factors to non‐hereditary congenital cataract; for example, GALK1, the most frequently mutated gene in this group of patients, was related to the posterior polar subtype of cataract.

Analysis of the efficacy of traumatic cataract extraction and intraocular lens implantation

Objective To analyse the efficacy of traumatic cataract extraction and intraocular lens(IOL)implantation. Methods Sixty eyes of 60 cases of traumatic cataract were enrolled, among which 39 patients received IOL implantation at stage I, and another 21 cases received IOL implantation at stageⅡ. Results After the IOL implantation surgery, the vision of patients in both groups were significantly improved, and the differences in improved vision level between two groups was not statistically significant(P=0.230~1.124). Additionally, the intraoperative complications were mainly posterior capsule rupture and vitreous loss, while postoperative complications included corneal edema, iridocyclitis, and posterior capsular opacification. Conclusion IOL implantation is an effective way to treat traumatic cataract and improve vision.Although the postoperative complications of IOL implantation at stage I were more than that of stageⅡ, they all could recover after timely and effective treatment which avoid the second surgery. Key words: Cataract, traumatic; Lens, intraocular; Timing, surgery; Efficacy

Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries

PurposeTo compare the ocular trauma score (OTS) and the paediatric penetrating ocular trauma score (POTS) as prognostic model for visual outcome in paediatric traumatic cataract cases after penetrating eye injuries. MethodsAll children younger than 16 years with unilateral traumatic cataract following penetrating trauma between 2007 and 2012 were retrospectively reviewed. Univariate chi-square analysis was conducted to identify the variables associated with profound visual loss. The area under the receiver-operating characteristic curves (AUROC) was used to assess the predictive ability of the two models. ResultsThe study group comprised 65 boys and 37 girls. The variables associated with profound visual loss were: a relative afferent papillary defect (RAPD) (P<0.001), poor initial vision (P=0.01), vitreous haemorrhage (P<0.001), retinal detachment (P<0.001), posterior penetrating site (P<0.001), hyphema (P<0.001), no intraocular len implantation (P<0.001) and endophthalmitis (P=0.001). OTS could not be calculated in 21 patients (20.6%) without clinical data on initial visual acuity and RAPD. For the patients with complete clinical data, POTS was similar to OTS in predicting poor vision (AUROC 0.904 vs 0.924) and in predicting good vision (AUROC 0.766 vs 0.736). For all the samples, POTS was a robust predictor of poor vision (AUROC 0.910) and had a moderate ability to predict good vision (AUROC 0.764). ConclusionOTS has high ability to predict visual outcome for paediatric traumatic cataract following penetrating ocular trauma. POTS is also a reliable prognostic model for very young child without initial vision or RAPD, but is only for penetrating eye injuries.

Intraocular Femtosecond Laser Use in Traumatic Cataract

To report the use of femtosecond laser cataract surgery in a traumatic case. A 38-year-old man had a penetrating eye injury while working with wire. The corneal laceration was sutured first. In the postoperative period, cortical cataract appeared in the crystalline lens; therefore, in the second session, cataract surgery was performed using a femtosecond laser system (Alcon-LenSx Lasers Inc.). Corneal incisions, an intact 4.5 mm capsulorhexis, and nucleus liquefaction were performed with the femtosecond laser. Corrected distance visual acuity was 0.9 1 month after surgery. Femtosecond laser is an effective method in traumatic cataract cases after penetrating eye injury. Corneal incisions, capsulorhexis, and nucleus liquefaction can be performed precisely and safety.

English

AIM: To study the role of B scan ultrasonography as a diagnostic and therapeutic tool in the management of traumatized eyes. MATERIAL AND METHODS: In a prospective study done in the Regional Institute of Ophthalmology, Amritsar during 2011--2013, B scan ultrasonography was done on 50 traumatized eyes. RESULTS: In the present study, maximum incidence of ocular trauma (36%) was in the age group of 15-29 years; more so in males (70%) with the incidence of close globe injuries being 60%. Patients mostly reported within 1 week of injury (70%). Intraocular lesions diagnosed on B-scan imaging were cataract 25(50%), dislocated lens 2(4%), vitreous hemorrhage 20(40%), posterior vitreous detachment 5(10%), retinal detachment 13(26%) and foreign body in 2(4%) cases. More than one finding was observed in 27 cases. In 25 cases with cataract, vitreous hemorrhage was seen in 5(20%), posterior vitreous detachment in 4(16%) and retinal detachment in 4(16%). Of the 20 cases of vitreous hemorrhage 3(15%) had retinal detachment. B-Scan imaging proved beneficial in the management of the traumatized eyes.12(24%) cases of traumatic cataract with no abnormality in the posterior segment underwent successful cataract extraction with IOL implantation. 27(54%) cases were referred to the vitreo-retinal surgeon while 11(22%) were followed up on appropriate medical treatment.

Epidemiology and Intermediate-Term Outcomes of Open- and Closed-Globe Injuries in Traumatic Childhood Cataract

To study epidemiology and intermediate-term outcomes of open- and closed-globe injuries (CGI) in traumatic childhood cataract. In this retrospective interventional case series, demographic parameters and history including type of injury of 57 children younger than 16 years with traumatic cataract were recorded; ocular examination included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and posterior segment evaluation. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Main surgical outcomes at 6 months comprised BCVA, residual refractive spherical error (SE), and postoperative complications, namely visual axis opacification (VAO) and amblyopia. Bow and arrow was the most common causal agent. Open-globe injury (OGI) was 3 times more frequent than CGI. There was a significant visual gain from baseline in both groups after cataract surgery (p<0.001); residual SE was greater in OGI (1.6 ± 0.95 SD) compared to blunt trauma (0.8 ± 0.55 SD; p = 0.001). Incidence of corneal scarring, iris distortion, posterior synechiae, and intraoperative posterior capsular tear was greater with OGI (p<0.05). A total of 86% of patients were rehabilitated with a primary/secondary IOL. Single-piece IOL implantation rate (p = 0.004) was significantly greater in CGI, with no statistical difference for in-the-bag IOL (p = 0.053) and IOL implantation rate (p = 0.16). Final BCVA was significantly better for in-the-bag IOL implantation compared to sulcus fixation. Postoperative complications included amblyopia (51%) and VAO (12%). Bow and arrow injury caused the maximum cases of traumatic cataract; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in pediatric traumatic cataracts.

Effect of secondary intraocular lens implantation in traumatic cataract with posterior capsular rupture

Objective To explore the effect of secondary intraocular lens (IOL) implantation in traumatic cataract with posterior capsular rupture.Methods 72 cases of traumatic cataract with posterior capsular rupture were divided into two groups:group A (36 eyes,36 cases) and group B (36 eyes,36 cases).Patients in group A were treated by traumatic cataract removal and primary IOL implantation.Patients in group B underwent traumatic cataract removal and secondary IOL implantation.The visual acuities and surgical complications were compared between two groups.Results There were 22 eyes (61.6％) in group A and 27 eyes (75.0％) in group B with visual acuities better than 0.5 at 8 weeks after surgery and the difference was statistically significant (x2 =8.175,P ＜ 0.05).The different degrees of inflammatory reaction were observed in two groups.The incidences of surgical complications in group B were much lower than that in group A (x2 =10.125,P ＜ 0.05).Conclusion The traumatic cataract with posterior capsular rupture treated by secondary IOL implantation can have better visual outcomes and less surgical complications compared with primary IOL implantation. Key words: Cataract, traumatic; Lens, intraocular; Implantation, secondary