Anne-Marie Yardley1, Asim Ali2, Nasrin Najm-Tehrani2, Kamiar Mireskandari2. 1. From the Capital and Coast District Health Board (Yardley), Wellington, New Zealand; the Department of Ophthalmology and Vision Sciences (Yardley, Ali, Najm-Tehrani, Mireskandari), University of Toronto, and the Hospital for Sick Children (Ali, Najm-Tehrani, Mireskandari), Toronto, Canada. Electronic address: annemarieyardley@gmail.com. 2. From the Capital and Coast District Health Board (Yardley), Wellington, New Zealand; the Department of Ophthalmology and Vision Sciences (Yardley, Ali, Najm-Tehrani, Mireskandari), University of Toronto, and the Hospital for Sick Children (Ali, Najm-Tehrani, Mireskandari), Toronto, Canada.
Abstract
PURPOSE: To describe refractive and visual outcomes of pediatric traumatic cataract requiring surgery and evaluate the factors influencing success. SETTING: Hospital for Sick Children, Toronto, Ontario, Canada. DESIGN: Retrospective case series. METHODS: Charts of children having lensectomy for traumatic cataract between January 1, 2000, and June 30, 2015, were reviewed for demographic information, visual and refractive outcomes, complications, and surgical details. RESULTS: One hundred six children (mean age 7.6 years ± 3.9 [SD]) were included. The median follow-up was 41 months (range 3 to 155 months). Seventy-nine children had open-globe injuries and 27 had closed-globe injuries. Patients with open-globe injuries were younger than those with closed-globe injuries (mean age 6.9 versus 10.4 years; P < .05). The final corrected distance visual acuity (CDVA) was 20/40 or better in 47 children. In the 94 children who had intraocular lens placement, 54% with open-globe injuries and 55% with closed-globe injuries achieved a mean absolute prediction error of 1.0 diopter or less in the early postoperative period. Open-globe injuries and amblyopia were associated with worse visual outcomes (odds ratio [OR], 2.8 and P = .03 versus OR, 2.4 and P = .04) and refractive outcomes (OR, 3.1 and P = .02 versus OR, 3.8 and P = .04). Age younger than 5 years was associated with worse refractive outcomes (OR, 2.88; P = .02). CONCLUSIONS: Children requiring surgery for traumatic cataract can have good visual and refractive outcomes. Those with open-globe and those with closed-globe injuries both had good early postoperative refractive accuracy. Sixty-three percent of children with closed-globe injuries attained a CDVA of 20/40 or better at the final follow-up.
PURPOSE: To describe refractive and visual outcomes of pediatric traumatic cataract requiring surgery and evaluate the factors influencing success. SETTING: Hospital for Sick Children, Toronto, Ontario, Canada. DESIGN: Retrospective case series. METHODS: Charts of children having lensectomy for traumatic cataract between January 1, 2000, and June 30, 2015, were reviewed for demographic information, visual and refractive outcomes, complications, and surgical details. RESULTS: One hundred six children (mean age 7.6 years ± 3.9 [SD]) were included. The median follow-up was 41 months (range 3 to 155 months). Seventy-nine children had open-globe injuries and 27 had closed-globe injuries. Patients with open-globe injuries were younger than those with closed-globe injuries (mean age 6.9 versus 10.4 years; P < .05). The final corrected distance visual acuity (CDVA) was 20/40 or better in 47 children. In the 94 children who had intraocular lens placement, 54% with open-globe injuries and 55% with closed-globe injuries achieved a mean absolute prediction error of 1.0 diopter or less in the early postoperative period. Open-globe injuries and amblyopia were associated with worse visual outcomes (odds ratio [OR], 2.8 and P = .03 versus OR, 2.4 and P = .04) and refractive outcomes (OR, 3.1 and P = .02 versus OR, 3.8 and P = .04). Age younger than 5 years was associated with worse refractive outcomes (OR, 2.88; P = .02). CONCLUSIONS:Children requiring surgery for traumatic cataract can have good visual and refractive outcomes. Those with open-globe and those with closed-globe injuries both had good early postoperative refractive accuracy. Sixty-three percent of children with closed-globe injuries attained a CDVA of 20/40 or better at the final follow-up.