Authors : Dr. Nasimul Gani Chowdhury; Sujit Kumar Biswas; Afrina Khanam; Farjana Akter Chowdhury

Volume/Issue : Volume 9 - 2024, Issue 6 - June

Google Scholar : https://tinyurl.com/ybpu7m6c

Scribd : https://tinyurl.com/8jpw89vc

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUN645

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Abstract : Aim: To evaluate the intraoperative complications & post- operative outcome of early intervention of traumatic cataract in children due to open globe injuries.  Materials and Methods: 40 cases of unilateral cataract having repair of open globe injuries previously were included in this prospective study. Primary repair of corneal injuries were done with 10-0 Nylon under general anesthesia. Secondary intervention with IOL implantation were done within 4 weeks of primary repair. Age range was 4-14 years and minimum follow up 3 months. Intraoperative and postoperative complications and final best-corrected visual outcome were recorded.  Results: All cases had pre-existing anterior capsular tear and flocculent lens matter in anterior chamber. IOL were implanted in the bag in 90% cases. Intra-operatively 4 cases revealed pre-existing posterior capsular hole and IOL were implanted in the sulcus. Synechiolysis was done in 3 cases. There was no iatrogenic PC rent. Postoperatively no cases showed synechiae formation, pupil capture and IOL displacement. Visual acuity was 6/9 to 6/60 in all cases and intraocular pressures were digitally normal. No optic atrophy and RD were noticed at last follow up. Most common causes of decreased vision were corneal scar and astigmatism.  Conclusion: Early cataract surgery with IOL implantation after repair of open globe injuries carries favorable intraoperative and postoperative outcome.

Keywords : Early Intervention, Traumatic Cataract in Bag Implantation, Sulcus Implantation.

References :

1. Acuna OM, Yen KG. Outcome and prognosis of pediatric patients with delayed diagnosis of open-globe injuries. J Pediatr Ophthalmol Strabismus. 2009 Jul-Aug;46(4):202-7; quiz 208-9. Doi: 10.3928/01913913-20090706-04. Epub 2009 Mar 20. PMID: 19645396.
2. Azimi A, Abdollahi F, Sadeghi E, Reza Farsiani A, Moshksar S, Nadi M. Epidemiological and Clinical Features of Pediatric Open Globe Injuries: A Report from Southern Iran. J Ophthalmic Vis Res. 2023 Feb 21;18(1):88-96. Doi: 10.18502/jovr.v18i1.12729. PMID: 36937192; PMCID: PMC10020783.
3. Çiloğlu, Emine and Fikret Ünal. “Surgical Approach to Pediatric Traumatic Cataract”. Cukurova Medical Journal, vol. 43, no. Ek 1, 2018, pp. 80-85, doi:10.17826/cumj.401046.
4. Du, Y., He, W., Sun, X. et al. Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study. Sci Rep 8, 2588 (2018). https://doi.org/10.1038/s41598-018-20982-1.
5. Doğan E, Çelik E, Gündoğdu K, Alagöz G. Characteristics of pediatric traumatic cataract and factors affecting visual outcomes. Injury. 2023;54:168–72. https://doi.org/10.1016/j.injury.2022.09.034
6. Fujikawa, A., Mohamed, Y.H., Kinoshita, H. et al. Visual outcomes and prognostic factors in open-globe injuries. BMC Ophthalmol 18, 138 (2018). https://doi.org/10.1186/s12886-018-0804-46.
7. Gogate P, Sahasrabudhe M, Shah M, Patil S, Kulkarni A. Causes, epidemiology, and long- term outcome of traumatic cataracts in children in rural India. Indian J Ophthalmol. 2012 Sep-Oct;60(5):481-6. Doi: 10.4103/0301-4738.100557. PMID: 22944764; PMCID: PMC3491280.
8. Henry, R.K., Bargoud, A., Syal, S. et al. The impact of primary repair timing on longitudinal visual outcomes after open globe injury. Graefes Arch Clin Exp Ophthalmol 261, 1195– 1203 (2023). https://doi.org/10.1007/s00417-022-05904-2.
9. He, Yan PhD*,†; Zhang, Ling MS*,†; Wang, Fang MS*,†; Zhu, Meidong MD, PhD‡,§; Wang, Yi MD*,†; Liu, Yong MD*,†. TIMING INFLUENCE ON OUTCOMES OF VITRECTOMY FOR OPEN-GLOBE INJURY: A Prospective Randomized Comparative Study. Retina 40(4):p 725-734, April 2020. | DOI: 10.1097/IAE.0000000000002447.
10. Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: A review of the literature. J Emerg Trauma Shock. 2015 Oct-Dec;8(4):216-23. Doi: 10.4103/0974-2700.166663. PMID: 26604528; PMCID: PMC4626939.
11. Memed, F. , Mariska, D. , Wahyu, M. , Irfani, I. , Oktarima, P. and Caesarya, S. (2020) Pediatric Traumatic Cataracts at a Tertiary Eye Center in Indonesia. Open Journal of Ophthalmology, 10, 332-340. Doi: 10.4236/ojoph.2020.104036.
12. Qayum S, Anjum R, Rather S. Epidemiological profile of pediatric ocular trauma in a tertiary hospital of Northern India. Chin J Traumatol 2018;21:100–3.
13. Rumelt, S., Rehany, U. The influence of surgery and intraocular lens implantation timing on visual outcome in traumatic cataract. Graefes Arch Clin Exp Ophthalmol 248, 1293– 1297 (2010). https://doi.org/10.1007/s00417-010-1378-x.
14. Shah M, Shah S, Upadhyay P, Agrawal R. Controversies in traumatic cataract Aug;48(4):251-8. doi: 10.1016/j.jcjo.2013.03.010. PMID: 23931462.
15. Shah MA, Shah SM, Shah SB, Patel UA. Effect of Interval between Time of Injury and Timing of Intervention on Final Visual Outcome in Cases of Traumatic Cataract. European Journal of Ophthalmology. 2011;21(6):760-765. Doi:10.5301/EJO.2011.6482
16. Tabatabaei, S., Rajabi, M., Tabatabaei, S. et al. Early versus late traumatic cataract surgery and intraocular lens implantation. Eye 31, 1199–1204 (2017). https://doi.org/10.1038/eye.2017.57
17. Xu YN, Huang YS, Xie LX. Pediatric traumatic cataract and surgery outcomes in eastern China: a hospital-based study. Int J Ophthalmol. 2013 Apr 18;6(2):160-4. Doi: 10.3980/j.issn.2222-3959.2013.02.10. PMID: 23638416; PMCID: PMC3633753.
18. Rodricks, D., Loya, A., Mohamed, M. et al. Visual outcomes of open globe injury patients with traumatic cataracts. Int Ophthalmol 42, 2039–2046 (2022). https://doi.org/10.1007/s10792-021-02195-0
19. Sen, Pradhnya MB BS, MS*; Shah, Chintan MB BS, DOMS; Sen, Alok MB BS, MS; Jain, Elesh DO, DNB; Mohan, Amit MB BS, MS. Primary versus secondary intraocular lens implantation in traumatic cataract after open-globe injury in pediatric patients. Journal of Cataract & Refractive Surgery 44(12):p 1446-1453, December 2018. | DOI: 10.1016/j.jcrs.2018.07.061
20. Yardley AM, Ali A, Najm-Tehrani N, Mireskandari K. Refractive and visual outcomes after surgery for pediatric traumatic cataract. J Cataract Refract Surg. 2018 Jan;44(1):85-90. Doi: 10.1016/j.jcrs.2017.09.033. PMID: 29502623.
21. Shah, M.A., Shah, S.M., Appleware, A.H., Patel, K.D., Rehman, R.M. and Shikhange, K.A. (201) Visual Outcome of Traumatic Cataract in Pediatric Age Group. European Journal of Ophthalmology, 22, 956-963. https://doi.org/10.5301/ejo.5000111
22. Zimmerman, A., Magalhães, I.H., Tanaka, H.A., Zimmermann, I.T. and Arieta, C.E.L. (2019) Pediatric Traumatic Cataract Review: Origin of the Trauma. Revista Brasileira de Oftalmologia, 78, 103-106. https://doi.org/10.5935/0034-7280.20180105
23. Adlina, A., Chong, Y. and Shatriah, I. (2014). Clinical Profile and Visual Outcome of Traumatic Paediatric Cataract in Suburban Malaysia: A Ten-Year Experience. Singapore Medical Journal, 55, 253-256. https://doi.org/10.11622/smedj.2014067
24. Zhu AY, Kraus CL. Practice Patterns in the Surgical Management of Pediatric Traumatic Cataracts. J Pediatr Ophthalmol Strabismus. 2020 May 1;57(3):190-198. doi: 10.3928/01913913-20200304-01. PMID: 32453853.
25. Memon MN, Narsani AK, Nizamani NB. Visual outcome of unilateral traumatic cataract. J Coll Physicians Surg Pak. 2012 Aug;22(8):497-500. PMID: 22868014.
26. Shah M, Shah S, Gupta L, Jain A, Mehta R. Predictors of visual outcome in traumatic cataract. World J Ophthalmol 2014; 4(4): 152-159 [DOI: 10.5318/wjo.v4.i4.152