Management of traumatic cataract in children

PURPOSE: To evaluate the presentation, mode of management, and clinical outcome of traumatic cataract in children. SETTING: L.V. Prasad Eye Institute, Hyderabad, India. METHODS: One hundred thirty-seven children (< 16 years) who developed traumatic cataract, seen between January 1988 and December 1993, were retrospectively analyzed. Nature of injury, type of cataract, management, and outcome were evaluated. RESULTS: The study group comprised 110 boys and 27 girls. Average follow-up was 11.7 months (range 1 week to 60 months). Most injuries (54.7%) were caused by a stick or a bow and arrow. Most (53.2%) of the cataracts were total. Corneal scarring (60.5%) and iris-related problems (49.6%) were the most common associated findings. Extracapsular cataract extraction with intraocular lens (IOL) implantation was performed in 65.67% of patients. Visual acuity improved form 20/200 or worse in 97.7% of patients preoperatively to 20/60 or better in 74.1% or patients postoperatively. Seventeen patients had associated posterior segment insult; most failed to recover satisfactory vision. Posterior capsule opacification (PCO) was noted in 42.9% of patients. CONCLUSIONS: Extracapsular cataract extraction with IOL implantation provides satisfactory results in children with traumatic cataract. Associated posterior segment complications and development of PCO are the major obstacles to visual rehabilitation.