VISUAL OUTCOME OF PAEDIATRIC TRAUMATIC CATARACT IN PAEDIATRIC OPHTHALMOLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL
AbstractBackground: Paediatric traumatic cataract is one of leading treatable cause of childhood blindness. The purpose of this study is to analyse number of avoidable blindness in children and to access final visual outcomes, causative factors, strategies for the prevention and management. Methods: One hundred and twenty patients of ocular traumatic cataract age between 2 months to 14 years were treated in Department of Paediatric Ophthalmology from April 2019 till April 2020wasprospectivelyreviewed. Data included age, gender, time of presentation, type of injury, anterior segment with fundus examination, time and type of surgery, visual outcome at presentation and final visual outcome. Visual acuity was assessed by fixation and following, Snellen’s chart according to patient’s age. Some patients underwent for lens aspiration and rest underwent for lens aspiration, posterior capsulotomy and anterior vitrectomy followed by intraocular lens implantation under general anaesthesia. Patients who lost follow ups for two months were not included in study. Analysis of data was done using SPSS for window version 24.0. Results: One hundred and twenty eyes operated for traumatic cataract among which 64 (53.34%) patients were males and 56 (46.66%) were females. The average age of patients was 7.8 years with traumatic cataract. Initial Uncorrected visual out come at the time of presentation ranged from 6/60 to light perception. 15 %of children with traumatic cataract had post-operative final visual outcome of better than 6/18. Conclusion: The commonest cause of ocular injuries in our pediatric ophthalmology department was domestic, mostly in 5–9 years of age with greater number in males. In traumatic cataract extraction final visual outcome depends on initial visual outcome, source and type of injury, duration of presentation, duration of surgery and complications.
Hiles DA, Wallar PH, Biglan AW. Amblyopia in paediatric cataract. J Pead Ophthalmol 1977;13:319–25.
Gulrez F. State of Pakistan’s Children. First Edition.Islamabad, Pakistan: Society for the Protection of the Rights of the Child. 2006.
Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol 1998;5(3):143–69.
Mahdi Z, Munami S, Shaikh ZA, Awan H, Wahab S. Pattern of eye diseases in children at secondary level eye department in Karachi. Pak J Ophthalmol 2006;22(3):145–9.
Sethi S, Sethi MJ, Saeed N, Kundi NK. Pattern of common eye diseases in children attending outpatient eye department Khyber Teaching Hospital. Pak J Ophthalmol 2008;24(4):166–71.
Parikshit G, Clare G. Blindness in children: a worldwide perspective. Community Eye Health 2007;20(62):32–3.
Kaur A, Agrawal A. Paediatric ocular trauma. Curr Sci 2005;89(1):43–46.
Umar MM, Abubakar A, Achi I, Alhassan MB, Hassan A. Pediatric cataract surgery in National Eye Centre Kaduna, Nigeria: outcome and challenges. Middle East Afr J Ophthalmol 2015;22(1):92–6.
Lithander J, Kindi HA, Tönjum AM. Loss of visual acuity due to eye injuries among 6292 school children in the Sultanate of Oman. Acta Ophthalmol Scand 1999;77(6):697–9.
Khatry SK, Lewis AE, Schein OD, Thapa MD, Pradhan EK, Katz J. The epidemiology of ocular trauma in rural Nepal. Br J Ophthalmol 2004;88(4):456–60.
Chandna A, Gilbert C. When your eye patient is a child. Community Eye Health 2010;23(72):1–3.
Kim KH, Ahn K, Chung ES, Chung TY. Clinical outcomes of surgical techniques in congenital cataracts. Korean J Ophthalmol 2008;22(2):87–91.
Noorani S, Ahmed J, Shaikh A, Shaikh ZA. Frequency of different types of paediatric ocular trauma attending a tertiary care paediatric ophthalmology department. Pak J Med Sci 2010;26(3):567–70.
Kuhn F, Pieramici DJ. Ocular trauma: principles and practice. Thieme; 2011.
Shah MA, Shah SM, Shah AH, Pandya JS. Visual outcome of cataract in pediatric age group: does etiology have a role? Eur J Ophthalmol 2014;24(1):76–83.
Lim Z, Rubab S, Chan YH, Levin AV. Management and outcomes of cataract in children: the Toronto experience. J AAPOS 2012;16(3):249–54.
Amaya L, Taylor D, Russell-Eggitt I, Nischal KK, Lengyel D. The morphology and natural history of childhood cataracts. Surv Ophthalmol 2003;48(2):125–44.
Perucho-Martínez S, De-la-Cruz-Bertolo J, Tejada-Palacios P. Pediatric cataracts: epidemiology and diagnosis. Retrospective review of 79 cases. Arch Soc Esp Oftalmol. 2007;82(1):37–42.
Alisacohen PS, Hershand Jan A. Fleishman. Management of trauma induced cataract. Optm Clin N Am 1995;8(4):633–46.
Khan MD, Kundi N, Mohammed Z, Nazeer AF. A 6 1/2-years survey of intraocular and intraorbital foreign bodies in the North-west Frontier Province, Pakistan. Br J Ophthalmol 1987;71(9):716–9.
Saxena R, Sinha R, Purohit A, Dada T, Vajpayee RB, Azad RV. Pattern of pediatric ocular trauma in India. Indian J Pediatr 2002;69(10):863–7.
Cillino S, Casuccio A, Di Pace F, Pillitteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol 2008;8(1):6.
Soliman MM, Macky TA. Pattern of ocular trauma in Egypt. Graefes Arch Clin Exp Ophthalmol 2008;246(2):205–12.
Morris DS, Willis S, Minassian D, Foot B, Desai P, MacEwen CJ. The incidence of serious eye injury in Scotland: a prospective study. Eye 2014;28(1):34–40.
Brophy M, Sinclair SA, Hostetler SG, Xiang H. Pediatric eye injury-related hospitalizations in the United States. Pediatrics 2006;117(6):e1263–71.
Miratashi MSA. Pediatric ocular trauma. Acta Med Iran 2006;44(2):125–130.
Aghadoost D, Fazel MR, Aghadoost HR. Pattern of pediatric ocular trauma in kashan. Arch Trauma Res 2012;1(1):35–7.
Cao H, Li L, Zhang M. Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010. PLoS One 2012;7(10):e48377.
MacEwen CJ, Baines PS, Desai P. Eye injuries in children: the current picture. Br J Ophthalmol 1999;83(8):933–6.
Soylu M, Demircan N, Yalaz M, Işigüzel I. Etiology of pediatric perforating eye injuries in southern Turkey. Ophthalmic Epidemiol 1998;5(1):7–12.
Takvam J, Midelfart A. Survey of eye injuries in Norwegian children. Acta Ophthalmol 1993;71:500–5.
Sminia ML, Odenthal MT, Wenniger-Prick LJ, Gortzak-Moorstein N, Völker-Dieben HJ. Traumatic pediatric cataract: a decade of follow-up after Artisan aphakia intraocular lens implantation. J AAPOS 2007;11(6):555–8.
Buckley EG. Hanging by a thread: the long-term efficacy and safety of transscleral sutured intraocular lenses in children (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2007;105:294–311.
Bellucci R, Pucci V, Morselli S, Bonomi L. Secondary implantation of angle-supported anterior chamber and scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg 1996;22(2):247–52.
Cheema RA, Lukran AD. Visual recovery in unilateral traumatic paediatric cataracts related with posterior chamber intraocular lens and anterior vitrectomy in Pakistan. Int Ophthalmol 1999;23(2):85–9.
Astle WF, Alewenah O, Ingram AD, Paszuk A. Surgical outcomes of primary foldable intraocular lens implantation in children: understanding posterior opacification and the absence of glaucoma. J Cataract Refract Surg 2009;35(7):1216–22.
Vasavada A, Desai J. Primary posterior capsulorhexis with and without anterior vitrectomy in congenital cataracts. J Cataract Refract Surg 1997;23(Suppl 1):645–51.