A prospective clinical evaluation and management of Traumatic Cataract

Abstract

Background: Ocular trauma is the leading cause of unilateral blindness all over the world. Traumatic cataract is a common sequela of ocular injuries in adults and children. The incidence of ocular injuries varies in different parts of the world. From India, the reported incidence is 20.53%. Management of traumatic cataract that results from either blunt or penetrating ocular trauma needs special consideration because of associated injury to ocular and periorbital structures. Materials and methods: This is a prospective study was conducted in the Department of Ophthalmology, RVM Institute of Medical Sciences and Research Centre in patients who was
presented with unilateral traumatic cataract, underwent surgical intervention and completed at least 6 months. Patients of both genders and all age groups with unilateral traumatic cataract were included in the study. Patient's data including demographic details, causative agents, initial visual acuity, intraocular pressure, slit lamp examination findings, B-scan findings, treatment / surgery, early and late complications and final outcome were obtained from patient's chart in the hospital record. Removal of cataract was performed as a second and separate procedure in patients of perforating ocular injury, intraocular lens (IOL) implantation was performed only in patients with adequate capsular support. Patients without any capsular support were kept aphakic. Anterior vitrectomy was performed in patients with posterior capsular tear and vitreous prolapse.
Result: Majority of the cases were seen in age group 5-14 years with male preponderance. 55% were penetrating trauma and 45% were blunt trauma. Corneal and iris tissue injuries were the most common associated injuries. Final visual acuity was 6/6-6/18 in 43% of patients, 6/24-3/60 in 31% of patients and less than 3/60 in 26% of patients. The most common late complication was PCO. On comparing final visual outcome among adult and paediatric age group, there was no significant difference. The time interval between injury and intervention had no significant effect on final visual outcome. 

Conclusion: In our study males were predominantly affected by traumatic cataract because of their nature of work and outdoor occupation. The age group of 5-25 years formed the core group of people to get traumatic cataract. The final visual outcome showed good result however the final visual outcome depends upon the extent of associated ocular injuries. Effective Intervention
and management are the key points in preventing monocular blindness due to traumatic cataract.