Traumatic Cataract Research Articles

Risk Factors for Retinal Detachment RepairAfter Pediatric Cataract Surgery inthe United States.

To determine the cumulative incidence of retinal detachment (RD) repair following pediatric cataract surgery and identify the associated risk factors. US population-based insurance claims retrospective cohort study. Patients ≤ 18 years old who underwent cataract surgery in 2 large databases: Optum Clinformatics (2003-2021) and IBM MarketScan (2007-2016). Individuals with ≥ 6months of prior enrollment were included, and those with a history of RD, RD repair, traumatic cataract, spherophakia, or ectopia lentis were excluded. The primary outcome was time between initial cataract surgery and RD repair. The risk factors investigated included age, sex, persistent fetal vasculature (PFV), prematurity, intraocular lens (IOL) placement, and pars plana lensectomy approach. Kaplan-Meier estimated cumulative incidence of RD repair 5years after cataract surgery and hazard ratios (HRs) with 95% confidence intervals (CIs) from multivariable Cox proportional hazards regression models. Retinal detachment repair was performed on 47 of 3289 children included in this study. The cumulative incidence of RD repair within 5years of cataract surgery was 2.0% (95% CI, 1.3%-2.6%). Children requiring RD repair were more likely to have a history of prematurity or PFV and less likely to have an IOL placed (all P<0.001). Factors associated with RD repair in the multivariable analysis included a history of prematurity (HR, 6.89; 95% CI, 3.26-14.56; P < 0.001), PFV diagnosis (HR, 8.20; 95% CI, 4.11-16.37; P < 0.001), and IOL placement (HR, 0.44; 95% CI, 0.21-0.91; P=0.03). Age at surgery, sex, and pars plana lensectomy approach were not significantly associated with RD repair after adjusting for all other covariates. Approximately 2% of patients will undergo RD repair within 5years of pediatric cataract surgery. Children with a history of PFV and prematurity undergoing cataract surgery without IOL placement are at the greatest risk.

DSAEK in corneal decompensation by Baikoff lens implant after traumatic cataract and superior iridodialysis

AbstractPurpose: To present the assessment and surgical approach to late pseudophakic bullous keratopathy in a case of pseudophakia with Baikoff type anterior chamber (AC) IOL implantation with haptics synechiated to the iridian stroma. We opted for Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK), which allowed us to solve the corneal decompensation.Methods: We present the case of a 72‐year‐old male with a history of traumatic cataract and superior iridodialysis, who was surgically treated with lens extraction and implantation of a three‐haptic Baikoff‐type AC IOL. During the 30 years after surgery, the patient remained stable. However, in 2021, he went for a revision with a decrease in visual acuity. During the slit‐lamp biomicroscopic examination and the images obtained, the presence of synechiae of the three haptics of the lens to the peripheral iridian stroma was evidenced, as well as the presence of generalized edema with increased thickness and loss of corneal transparency, which did not subside with medical treatment.Results: Given the need for surgical intervention, the risk–benefit of performing a lens explant was studied. It was decided to perform a DSAEK endothelial transplantation keeping the IOL in its position, given the existence of a wide iridian dialysis and a wide anterior chamber. During the operation, the implanted gas bubble allowed the graft to adhere properly, although it did not remain in the anterior chamber, due to the presence of the traumatic superior iridodialysis. However, in the immediate postoperative period, the graft of the posterior corneal layers remained adhered without the need of the gas bubble, resolving the previous bullous keratopathy.Conclusions: Late corneal decompensation is a complication to be taken into account in eyes with AC IOL. On the other hand, DSAEK offers advantages in the ease of positioning and maintenance of the graft compared to DMEK in cases with iridodialysis, obtaining a prompt recovery with good refractive results.

Central macular thickness and subfoveal choroidal thickness changes on spectral domain optical coherence tomography after cataract surgery in pediatric population.

To evaluate the central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) changes on spectral domain optical coherence tomography (SD-OCT) after cataract surgery with intraocular lens (IOL) implantation in a pediatric population. This was a longitudinal, prospective, interventional study which included 90 pediatric patients who underwent cataract extraction with IOL implantation. Serial SD-OCT scans were done at postoperative day 1, 1-month, and 3-month follow-up. CMT and SFCT were measured at each visit. A statistically significant increase in CMT was noted at 1 month (from 199.3 μm to 210.04 μm) post surgery, which declined over a 3-month period (202.70 μm, P = 0.0001). In case of SFCT, a constant increase was observed for over 3 months of follow-up (baseline: 296.52 μm; 1 month: 309.04 μm; and 3 months: 319.03 μm, P = 0.0001). The traumatic cataract group showed more pronounced changes in CMT and SFCT than the non-traumatic cataract group. No significant difference was observed regarding these parameters between those who underwent primary posterior capsulotomy (PPC) versus those who did not. None of the patients in the study group developed cystoid macular edema. These posterior segment-related anatomical changes did not affect the final visual outcomes. Cataract surgery induces potential inflammatory changes in the macula and choroid in pediatric patients. Such changes are more pronounced in trauma-related cases; however, they are not significant enough to affect the visual outcomes. Similarly, the additional surgical step of PPC does not induce significant anatomical or functional changes.

Characteristics and Outcomes of Electric Bicycle-Related Open-Globe Injuries in a Tertiary Hospital in North China.

The aim was to describe the characteristics and outcomes of patients treated for electric bicycle-related open-globe injuries (OGIs). A retrospective chart review of all patients who presented with electric bicycle-related OGIs was performed at the Hebei Eye Hospital in North China between January 2012 and December 2018. Demographic data, injury type, presenting clinical examination findings, best-corrected visual acuity (BCVA), secondary ocular complications, necessary surgical procedures and long-term outcome data were recorded. Twenty-six patients with electric bicycle-related OGIs met the inclusion criteria and were enrolled in the study. Eighteen of the 26 patients (69.2%) were males. the average age of these patients was 44.0 years old. The injuries peaked in winter in the hour between 15:00 and 20:00. Among the patients, 23 (88.5%) were farm workers, 2 (7.7%) were industrial workers, 1 (3.8%) was student. The types of OGIs were 23 ruptures (88.5%), 3 penetrating injuries (11.5%). Data on zone of injuries included 1 zone I injuries (3.8%), 12 zone II injuries (46.2%), 13 zone III injuries (50.0%). Nine eyes (34.6%) had traumatic cataract, 24 eyes (92.3%) had vitreous hemorrhage, 20 eyes (79.9%) had retinal detachment, 19 eyes (73.1%) had choroidal detachment. Ten eyes (38.4%) had hand motion or worse vision at final follow-up. four eyes (15.4%) which had injuries involving all 3 zones resulted in enucleation or evisceration. With respect to BCVA, the initial BCVA was 2.7±0.3 and the final BCVA was 2.0±0.7, indicating that the patients' BCVA was significantly improved by surgery ( t =4.3, P <0.001). Electric bicycle-related OGIs may have severe consequences. Modern surgical techniques can increase the rate of globe salvage although final vision remains poor. Therefore, increased awareness, proposed policies and suggestions should focus on regulating the use of electric bicycles and reinforcing laws and regulations to improve safety and prevent injuries.

Strabismus and Nystagmus in Patients With Pediatric Cataracts: Study Using Insurance Claims Data

To describe the characteristics and prevalence of strabismus and nystagmus in children diagnosed with cataracts using a national insurance claims database. Population-based retrospective cohort study. Patients aged <13 years diagnosed with cataracts (traumatic cataracts excluded) and enrolled continuously in their health care program for ≥5 years after their first cataract diagnosis were identified in a retrospective review of 66 million charts in Optum's de-identified Clinformatics Data Mart Database between 2003 and 2015. Patients were categorized based on age of their first diagnosed cataract, and if cataract surgery was performed. Clinical and demographic factors associated with the occurrence of strabismus and nystagmus were evaluated. Of 1636 children diagnosed with cataract, 434 (26.5%) and 109 (6.7%) were diagnosed with strabismus and nystagmus, respectively. Both strabismus and nystagmus were more common in those who underwent cataract surgery (P < .001) and in patients diagnosed with cataract at ≤12 months of age (P < .001). Survival analysis demonstrated that strabismus and nystagmus may be diagnosed 8 years after the initial cataract diagnosis. Cox proportional hazard regression analyses revealed strabismus was associated with cataract surgery, nystagmus, and the diagnosis with cataract at ≤12 months and cataract surgery at >12 months. As strabismus and nystagmus occur more frequently in children diagnosed with cataracts necessitating cataract surgery, regular long-term follow-up is crucial for these children to monitor for the development of strabismus and nystagmus.

A neglected case of blunt eye injury leading to pediatric cataract: a lifetime consequence case report

Background: A pediatric traumatic cataract is one of the children's main causes of unilateral visual impairment. It is defined as a permanent opacification of the lens caused by penetrating or blunt trauma to the eye, which might damage the vision. A traumatic pediatric cataract is preventable and treatable. This case study aims to evaluate a neglected case of blunt eye injury leading to pediatric cataracts. Case Description: A 15-year-old boy came with chief complaints of decreased visual acuity in his left eye for the last 2 years. He has a history of blunt eye injury around 3 years prior in the left eye but left untreated. The patient's visual acuity was 1 per light perception in the left eye. An ophthalmologic examination of the left eye showed an opacity in the lens. The posterior segment cannot be examined. The patient was assessed with a traumatic cataract and was planned to be operated on, but the parents refused. Conclusion: Prompt first aid and timely surgical intervention are necessary for optimal results. Parents play a critical role in the patient's prognosis by observing closely after eye trauma and bringing their children to the right medical facility.

Role of B-Scan Ultrasonography in Pre-Operative Cataract Patients Attending Services Hospital, Lahore

Aim: The present study aimed to assess the role of B-scan in pre-operative cataract patients. Material and Methods: This prospective diagnostic study was conducted on 94 cataract patients in Ophthalmology Department, Services Hospital, Lahore from January 2021 to June 2021. Patients of either gender regardless of age having cataract were enrolled. Clinical history, detailed examination, and B-scan ultrasound of each individual was recorded. Individuals were examined in a lie supine position on the table and contact method was used. Coupling gel was applied and a probe was placed on the closed eyelid. B-scan ultrasound took images of different sections such as longitudinal, axial, and transverse sections. Resolution of the images was optimized by maintaining adequate intensity with the lowest possible decibel gain. Results: Out of 94 cataract patients, the number of male and female patients was 54 (57.4%) and 40 (42.6%) respectively. The incidence of traumatic and non-traumatic cataract patients was 20 (21%) and 74 (79%) respectively. About 42 (44.7%) cataract patients had a rural background and 52 (55.3%) had an urban background. The age distribution of cataract patients was as follows: 12 (12.8%) 1-20 years, 4 (4.3%) in 21-30 years, 19 (20.2%) in 31-40 years, 21 (22.3%) in 41-50 years, 32 (34%) in 51-60 years, and 6 (6.4%) &gt;60 years. Of the traumatic cataract patients, posterior segment pathology was observed in 8 (40%) only whereas 12 (60%) had no posterior segment pathology. Out of traumatic cataract patient’s posterior segment pathology, the incidence of retinal detachment, vitreous hemorrhage, posterior vitreous detachment, intraocular foreign body and posterior staphyloma was 2 (25%), 1 (12.5%), 1 (12.5%), 3 (37.5%), and 0 (0%) respectively. Out of non-traumatic cataract patients, the incidence of posterior segment pathology and no posterior segment pathology was observed in 14 (18.9%) and 60 (81.1%) respectively. Among 14 posterior segment pathology, the incidence of retinal detachment, vitreous hemorrhage, posterior vitreous detachment, intraocular foreign body, and posterior staphyloma was 4 (28.6%), 3 (21.4%), 2 (14.3%), 2 (14.3%), and 3 (21.4%) respectively. Conclusion: The present study found that B-scan is a better diagnostic modality for the detection of posterior segment pathology in traumatic and non-traumatic cataract patients. Two dimensional B-scan can be effective in routine examination of pre-operative cataract patients. Three-dimensional B-scan could be considered in cases where two-dimensional does not provide sufficient help in assessment of posterior segment pathology in cataract patients. Keywords: Cataract patients, Traumatic cataract patients, Non-traumatic cataract patients, B-scan

Predictors of Long-term Ophthalmic Complications after Closed Globe Injuries Using the IRIS® Registry (Intelligent Research in Sight)

To identify clinical factors associated with the need for future surgical intervention following closed globe ocular trauma. Retrospective cohort study. Patients in the American Academy of Ophthalmology Intelligent Research in Sight (IRIS®) Registry with a diagnosis of closed globe ocular trauma occurring between 2013 and 2019, identified using International Classification of Disease, 10th Revision and Systematized Nomenclature of Medicine codes. Diagnosis codes were used to identify multiple concomitant diagnoses present on the date of closed globe ocular trauma. Survival analyses were performed for each outcome of interest, and linear regression was used to identify clinical factors associated with the risk of surgical intervention. Outcomes included retinal break treatment, retinal detachment (RD) repair, retinal break treatment or RD repair, glaucoma surgery, and cataract surgery. Of the 206 807 patients with closed globe ocular trauma, 9648 underwent surgical intervention during the follow-up period (mean, 444 days): 1697 (0.8%) had RD repair, 1658 (0.8%) had retinal break treatment, 600 (0.3%) had glaucoma surgery, and 5693 (2.8%) had cataract surgery. Traumatic cataract was the strongest risk factor for cataract surgery (hazard ratio, 13.0; 95% confidence interval, 10.8-15.6), traumatic hyphema showed highest risk for glaucoma surgery (7.24; 4.60-11.4), and vitreous hemorrhage was the strongest risk factor for retinal break treatment and detachment repair (11.01; 9.18-13.2 and 14.2; 11.5-17.6, respectively) during the first 60 days after trauma date. Vitreous hemorrhage was a risk factor for cataract surgery at > 60 days after trauma date only. Iris-angle injury was the strongest risk factor for glaucoma surgery > 60 days after trauma, while vitreous hemorrhage remained the strongest factor for retinal break treatment and detachment repair at > 60 days. Traumatic hyphema was a risk factor for all surgical outcomes during all follow-up intervals. Diagnosis of concomitant traumatic cataract, vitreous hemorrhage, traumatic hyphema, and other risk factors may increase the likelihood of requiring surgical intervention after closed globe ocular trauma.

Visual Outcomes of Secondary Lens Implants in Children with Different Etiologies

Aim: This study investigated visual outcomes and factors that impact vision in children receiving secondary Intraocular Lens (IOL) implants. Methods: Children who had traumatic or congenital cataracts and underwent secondary lens implantation for aphakia at Drashti Netralaya between 2000 and 2019 were retrospectively examined. We included all the eyes with secondary implants for aphakia correction with placement either in the bag or sulcus or through scleral fixation. We obtained data from electronic medical records and analyzed using SPSS 22 through descriptive analysis, cross tabulation and t test. We evaluated visual outcomes among different patients. Results: Our cohort consisted of 84 eyes (mean age: 7.88 ± 6.07 years). Of the 84 eyes, 24 (28.6%) and 60 (71.4%) were female and male patients, respectively and 32 (38.1%) had traumatic cataract. We observed significant improvements in vision following lens implantation (p=0.000). Those with nontraumatic cataracts exhibited better outcomes that did the traumatic cataract group (p=0.004). Corneal opacity caused comorbidities in the traumatic group (14/52, 14.29%). Visual outcomes significantly improved in young patients and were not affected by other variables. Conclusion: Secondary lens implantation significantly improved vision in aphakic children. Young patients and those with nontraumatic cataracts demonstrated more favorable visual outcomes.

Toric trans-scleral plugs IOL to correct aphakia with significant corneal astigmatism.

To describe the use of toric trans-plugs IOL to correct aphakia with significant corneal astigmatism. Case report and literature review. A 62-year-old man with an history of aphakia in his left eye after a traumatic cataract extraction and significant corneal astigmatism was referred to our clinic. Surgery plan was cataract remnants removal and secondary IOL implantation of toric sutureless trans-scleral plugs fixated IOL (FIL SSF, Soleko, Italy). The postoperative course was uneventful. At 12 months, the IOL was well-centered and the optic alignment remained stable with minimal total astigmatism. The e uncorrected distance visual acuity (UDVA) was 20/25 Snellen while correct distance visual acuity (CDVA) was 20/20 with a manifest refraction of -0.25-50 40° D; the patient was satisfied by the visual outcome. This novel toric trans-scleral plug fixated lens provides valuable outcomes also for astigmatic correction for a comprehensive correction of the aphakia in patients with poor zonular support and high expectations for postoperative visual quality.

Eye ball deviation patterns in traumatic cataract among children in Uttar Pradesh of India

Paediatric cataract is an important cause of treatable childhood blindness, provided it is recognized and managed early. Timely diagnosis, management, and visual rehabilitation of a child with a paediatric cataract are crucial determinants of a favourable prognosis. This particular topic, study of pattern of deviation of eye ball after traumatic cataract in children was selected because of the difference between the firm literature of Keith Lyle and the clinical observations. This study includes analysis of 25 patients. The key findings of this study were: Maximum incidence of traumatic cataract was seen in 6-10 years of age group, that too more commonly in boys and it was 2.5 times more than that of girls. lncidence of perforating injuries leading to cataract was 1.5 times more common than blunt trauma. In paediatrics cataract, the Diminution of vision in cases of traumatic cataract is usually at the level of mature or hypermature cataract. 40% of cases showed deviation in the range of 11-20° (irrespective to divergence or convergence). There was higher incidence of Exotropia than esotropia. Originally eye was divergent as per evolution of binocular vision in primates &amp; our study also came out with a conclusion that when there is no force or compulsion of binocular Vision, most of the eyes tended to be Divergent in children after traumatic cataract.

MANAGEMENT CASE OF POST PHAKIC INTRAOCULAR LENS IMPLANT IN HIGH MYOPIA WITH COMPLICATED CATARACT AFTER VITRECTOMY: POST SURGERY CHALLENGES

Introduction: To highlight the therapeutic dilemma in managing complications in high myopia patient with complicated cataract after vitrectomy who previously had refractive surgery.&#x0D; Case Report: A 37-years old man, presented with half the right eye view was being blocked by a black curtain for one week before admission. He had a history of high myopia on both eyes and underwent phakic intraocular lens (PIOL) implantation 12 years ago. Presenting visual acuity (VA) of the right eye was hand motion (HM). Retinal detachment (RD) on inferior side, and clear lens with anterior chamber (AC) PIOL were found in the examination. Patient underwent vitrectomy, endolaser, and silicone oil in the next four days. A sudden severe pain with red-eye was found one month after surgery, intraocular pressure (IOP) was increased to 43 mmHg, the lens was white opaque with lens material seen in AC. &#x0D; Discussion: The diagnosis of traumatic cataract and lens-particle-induced glaucoma was made. Lens mass evacuation surgery was performed after initial antiglaucoma medication. Posterior capsule rupture was found intraoperatively with only a small amount of lens mass remaining. Visual acuity result after the second surgery is still dissatisfied with the presence of rubeosis iridis, with the possibility of retinal re-detachment was still present.&#x0D; Conclusion: High myopia still poses a greater risk of ocular complications. It can be corrected by refractive surgery, with expensive cost and it will not prevent potential future ocular problems. Repeated assessment before and after refractive surgery procedure is mandatory in order to prevent sight-threatening complications of high myopia which might lead to other blinding complications.

Characteristics of pediatric traumatic cataract and factors affecting visual outcomes

PurposeTo evaluate the clinical characteristics, surgical approach and visual results in pediatric traumatic cataract. Material and methodsData of pediatric and adult traumatic cataract patients were retrospectively analyzed. Age, gender, cause and zone of trauma, additional clinical findings, initial and final visual acuity (VA) were analyzed and compared between groups. ResultsThe mean age of 18 patients in the pediatric group was 9.4(SD 5.7); 18 patients in the adult group was 47.8(16.2) years. There was a male predominance in both groups (12/16 male, respectively). The most common cause of trauma was sharp metal objects (50%) in the pediatric group and wooden and traffic accidents (33%) in the adult group. The initial mean VA of the patients were 0.03(0.09), 0.09(0.1) in the pediatric and adult groups, respectively, (p: 0.34). The mean ocular trauma score (OTS) was 51.4(16.4) and 59.6(10.5) in the pediatric and adult groups, respectively (p: 0.09). Simultaneous surgery was performed in 5 (28%) eyes in both groups. Subsequent lens extraction and IOL implantation were performed in 10 of pediatric and 13 of adult patients. The final VA was 0.3(0.7), 0.3(0.4) in the pediatric and adult group, respectively (p: 0.94). Final VA was correlated with OTS in both of the groups and the presence of additional surgery in the pediatric group. ConclusionTraumatic cataract is a major cause of visual loss in children. Lower OTS and presence of additional surgery were the prognostic factors for poor final VA in the pediatric cases. Optimal timing and accurate management of traumatic cataract are important in the pediatric population.

Penetrating Ocular Injury Management in Intraocular Foreign Body (IOFB) and Traumatic Cataract

Highlight: The management of penetrating ocular injury with IOFB and traumatic cataracts needs a thorough examination of the mechanism of injury, location, size, and composition of IOFB. Endophthalmitis, retinal detachment, and development of PVR are potentially vision-threatment. Abstract: Most IOFB are metallic and found in males of productive age as a consequence of work-related accidents. A 45-year-old man complained of sudden blurred vision in the left eye (3/60 pinhole 5/12) after getting hit by a foreign body when cutting grass with a lawn mower. Anterior segment examination revealed a 10 mm long, one-plane, straight, full thickness, already sutured inferonasal corneal laceration, inferonasal traumatic iridectomy size 3x7 mm, and opaque lens. Head CT-scan revealed opacity with metallic density intraocularly. Ultrasonography revealed an echogenic lesion, particle-shaped with 100% RCS complex density, located at the inferonasal of the vitreous cavity. Focal laser photocoagulation was performed preoperatively because there was a tear at the superonasal of the retina. The patient underwent cataract extraction, intraocular lens implantation, vitrectomy, and IOFB extraction in a one-step procedure. IOFB was found at the inferonasal side of a vitreous cavity with size 3 x 1 mm, metallic, and not attached to the retina. Silicon oil tamponade was used as a precaution because there were retinal tears. Postoperatively, the left eye's visualacuity was 5/20. After 6 months, the silicon oil was evacuated and the visual acuity became 5/8.5.

Systemic and Ocular Adverse Events with Intravitreal Anti-VEGF Therapy Used in the Treatment of Diabetic Retinopathy: a Review.

Intravitreal anti-vascular endothelial growth factor (VEGF) agents are used routinely in the management of neovascular conditions including proliferative diabetic retinopathy and diabetic macular edema. While the efficacy of anti-VEGF agents has been well-validated, their ocular and systemic adverse events should always be considered and discussed with patients. The aim of this review is to discuss the most recent literature reports regarding the various ocular and systemic adverse events associated with intravitreal anti-VEGF treatment in diabetic retinopathy. The most frequently reported adverse ocular events include subconjunctival hemorrhage, vitreous hemorrhage, increased intraocular pressure, uveitis, endophthalmitis, ocular surface disease, and traumatic cataract. Subconjunctival hemorrhage and vitreous hemorrhage are the most common ocular adverse events reported with intravitreal anti-VEGF treatment. The most serious (though rare) ocular adverse events include endophthalmitis and rhegmatogenous retinal detachment. A consensus regarding the association of systemic adverse events (such as myocardial infarction, stroke, and death) with intravitreal anti-VEGF treatments has not been established. Intravitreal anti-VEGF therapy is used in the treatment of diabetic retinopathy, macular degeneration, and other diseases. These agents are associated with a variety of ocular and systemic adverse events that ophthalmologists should always consider.

Predictive value and applicability of ocular trauma scores and pediatric ocular trauma scores in pediatric globe injuries

AIM: To evaluate the predictive value and applicability of Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) for closed and open globe injuries in the pediatric group. METHODS: A retrospective study of closed and open globe injuries in children age of 0-18-year-old between 2012-2019 was conducted. Medical records were collected, and injuries were classified using Birmingham Eye Trauma Terminology System (BETTS). The predictive value and applicability of both OTS and POTS to final visual acuity (VA) were analyzed. RESULTS: Of 84 patients, 59 (70.2%) presented with closed globe injuries (CGI) and 25 (29.8%) with open globe injuries (OGI). The mean of initial VA was 0.832±0.904 logMAR. OTS and POTS was calculated. Initial VA (P&lt;0.001) and traumatic cataract (P&lt;0.001) were significantly associated with visual outcome, followed by organic/unclean wound (P=0.001), delay of surgery (P=0.001), iris prolapse (P=0.003), and globe rupture (P=0.008). A strong correlation between OTS and POTS and final VA (r=-0.798, P&lt;0.001; r=-0.612, P&lt;0.001) was found. OTS was more applicable in all age group of pediatric and in contrast to POTS, it was designed for 0-15 years old. POTS requires eleven parameters and OTS six parameters. Even though initial VA was not available, we could still calculate into POTS equation. CONCLUSION: OTS and POTS are highly predictive prognostic tools for final VA in CGI and OGI’s in children.

Clinical profile of pediatric traumatic cataract in tertiary hospital

Traumatic cataract is one of the leading causes of monocular visual disability and blindness in pediatric that surgically manageable. Our objective is to describe the characteristics of pediatric traumatic cataract in tertiary hospital.

Analysis of 74 Open Globe Injuries Requiring Vitreo-Retinal Intervention and Its Correlation with Ocular Trauma Score

Aim: Retrospective study of 74 eyes with open globe injuries requiring V-R Intervention &amp; its correlation with ocular trauma score.&#x0D; Results: Commonest cause of injury: Hammer-chisel/stone in 32.43% (24) &amp; Thorn/wooden stick 27% (20). Average age-30.5yrs. Average interval between trauma &amp; intervention was -10.04days (4hrs – 52days).&#x0D; Discussion: Delay of presentation to ophthalmologist has lot of significance,high incidence of endophthalmitis &amp; retinal detachment compared to other studies. Surgical outcome shows lower incidence of NO Light Perception &amp; Significant reduction in number of cases with &lt;/=HM. Patients had better prognosis &amp; visual outcome, higher incidence of 1/200- 20/50; 35.14% cases with &gt;20/200. 60% of our cases had traumatic cataract, visual acuity may be underestimated in traumatic cataract. Faulty Projection of rays probably would be better criteria than RAPD. Extension of wound beyond pars plana, and aniridia (6.7%) are important risk factor.&#x0D; Conclusion: Modification of raw points is recommended in OTS criteria in Indian scenario.

New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models.

Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer's exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. We enrolled 124 eyes. Patients' mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed- and open-globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. All the examined scores can be helpful in estimating VA following treatment.

Outcomes of unilateral cataract surgery in children 2-7 years of age: a comparison to surgery in toddlers and infants

To compare outcomes of unilateral cataract surgery in children aged 2-7 years with the outcomes reported in younger children. The medical records of patients who underwent unilateral cataract surgery between the ages of 2-7 years were reviewed retrospectively. Traumatic cataracts and ectopia lentis were excluded. Outcomes were compared to those of the Infant Aphakia Treatment Study (IATS) for infants up to 7 months of age and the Toddler Aphakia and Pseudophakia Study (TAPS) for toddlers between 7-24 months of age who underwent unilateral cataract surgery. A total of 68 children were included, with a mean follow-up of 4.3 years. The proportion of intraoperative complications (7%) was significantly lower than that reported in IATS but not significantly different from that of TAPS. In our older cohort, more children (41%) had visual acuity better than 20/40 compared to infants (23% [P < 0.05]) and toddlers (11% [P < 0.001]), with a final median visual acuity of 20/44. The proportion of adverse events in our older cohort was reduced (7%) compared to that of infants (81%) and toddlers (24%). Additional unplanned intraocular surgeries occurred less often (6%) than in the infant cohort (72%). No patients developed glaucoma. Cataract surgery in slightly older children carries less risk of vision-threatening complications and adverse events compared to infants and results in better visual outcomes than in toddlers. Once the decision is made to pursue surgery on a visually significant cataract, the age of the child should determine which relevant risks are emphasized in the informed consent discussion.