Visual outcomes in pediatric traumatic cataract

To study epidemiology, biometry and visual outcomes (with or without posterior capsulorhexis) in cases of pediatric traumatic cataract. This was a prospective observational study conducted on 30 children of traumatic cataract belonging to an age group of less than 16 years. All patients were subjected to detailed history and ocular examination. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Posterior capsulorhexis with posterior optic capture was done in all patients presenting with primary posterior capsular opacity. All patients were followed up till 6 months and surgical outcomes in terms of Best Corrected Visual Acuity (BCVA), and visual axis opacification (VAO) were observed. Firecracker injury was found to be the most common causal agent, followed by arrow and ball injuries. Males were more commonly injured than females (70%:30%). Open-globe injury was more frequent than closed globe injury (CGI) (53.3%:46.7%). Anterior capsular rupture was the most frequent preoperative complication. Mean axial length was 22.53 which was not significantly different from the fellow eye. 3 patients were left aphakic, 10 patients underwent single piece IOL implantation and 16 patients underwent multipiece IOL implantation. Anterior chamber IOL (ACIOL) was implanted in one case. Intraoperatively 6 patients were found to have posterior capsular plaque and were implanted with multipiece IOL with posterior optic capture. Visual acuity significantly improved in 21 out of 30 eyes from baseline after cataract surgery (p<0.001). 9 patients (30%) had posterior capsular opacification (PCO) on follow up. Posterior capsular opacity in pediatric traumatic cataracts can be effectively managed with posterior capsulorhexis and posterior optic capture.

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Clinical Outcomes of Management of Traumatic Cataract in a Tertiary Care Centre

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0802.07 ◽

2020 ◽

pp. 20-23

Author(s):

anuradha bharati ◽

pallavi sharma ◽

sachit mahajan ◽

Bhavani Raina ◽

Sanjay Kai

Keyword(s):

Visual Acuity ◽

Tertiary Care ◽

Final Visual Acuity ◽

Posterior Capsular Opacification ◽

Care Centre ◽

Traumatic Cataract ◽

Tertiary Care Centre ◽

Visual Outcomes ◽

Operative Complications ◽

Post Operative Complications

Background and Objectives : Ocular trauma can lead to development of cataract when natural lens is damaged by either blunt or penetrating injury. The management of traumatic cataract follows the same principle as for senile cataract but associated damage to ocular tissues and several post-operative complications may lead to suboptimal visual outcome. This study was conceptualized to evaluate the visual outcomes following management of traumatic cataracts. Material and Methods : This prospective, longitudinal study was conducted on 80 patients with traumatic cataract in tertiary care centre. Patients were managed surgically and were followed up for a period of six months. Visual acuity was measured at every follow-up visit and any post-operative complications were noted and managed, accordingly. Final visual acuity was assessed at the end of six months. Results: Maximum cases of traumatic cataract (53.75%) were observed in age group of <20 years with male to female ratio of 2.63:1. Maximum patients (92.15%) were implanted posterior chamber intraocular lens, either as a primary or secondary procedure. Uveitis and posterior capsular opacification were most common post-operative complications (30%) and 68.75% cases achieved a final visual acuity of 6/6-6/ 18 at the end of six months. Conclusions Traumatic cataract is an important cause of ocular morbidity specially in young patients. Surgery in cases of traumatic cataract can yield good visual outcomes if posterior segment is not involved and if post-operative complications are managed efficiently.

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Cataract Surgery with or without Intraocular Lens Implantation in Pediatric Uveitis: A Systematic Review with Meta-Analyses

Journal of Ophthalmology ◽

10.1155/2021/5481609 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Diana Chabané Schmidt ◽

Moug Al-Bakri ◽

Asrin Rasul ◽

Regitze Bangsgaard ◽

Yousif Subhi ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Complication Rates ◽

Visual Axis ◽

Iol Implantation ◽

Pediatric Uveitis ◽

Aphakic Eyes ◽

Meta Analyses ◽

Modern Era

Purpose. To systematically review the results of comparative studies of modern cataract surgery in pediatric uveitis with or without intraocular lens (IOL) implantation and to perform comparative meta-analyses to compare visual acuity outcomes and complication rates. Methods. On 12 November 2020, we systematically searched the Cochrane Central, PubMed/MEDLINE, EMBASE, ClinicalTrials.gov, and all affiliated databases of the Web of Science. Two authors independently reviewed studies and extracted data. Studies were reviewed qualitatively in text and quantitatively with meta-analyses. Outcome measures were preoperative and postoperative best-corrected visual acuity (BCVA), inflammation control, and rates of postoperative complications. Results. Ten studies of 288 eyes were eligible for review of which the majority were eyes with juvenile idiopathic arthritis-associated uveitis. Summary estimates revealed that the BCVA was better in pseudophakic eyes vs. aphakic eyes (1-year postoperative: −0.23 logMAR, 95% CI: −0.43 to −0.03 logMAR, P = 0.027 ; 5-year postoperative: −0.35 logMAR, 95% CI: −0.51 to −0.18 logMAR, P = 0.000036 ). Pseudophakic eyes had more visual axis opacification (OR 6.76, 95% CI: 2.73 to 16.8, P = 0.000036 ) and less hypotony (OR 0.19, 95% CI: 0.04 to 0.95, P = 0.044 ). Conclusions. In modern era cataract surgery on eyes with pediatric uveitis with IOL implantation leads to satisfactory and superior visual outcomes and no differences in complication rates apart from an increased prevalence of visual axis opacification and a decreased prevalence of hypotony when compared to aphakia. However, limitations of the retrospective design and the presence of selection bias necessitate a careful interpretation.

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Visual outcome of cataract surgery with IOL implantation in traumatic cataract among 189 children: The Lahan experience

Journal of Chitwan Medical College ◽

10.3126/jcmc.v5i3.16519 ◽

2017 ◽

Vol 5 (3) ◽

pp. 1-10

Author(s):

L R Puri ◽

G S Shrestha

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Anterior Segment ◽

Visual Outcome ◽

Traumatic Cataract ◽

Eye Injuries ◽

Iol Implantation ◽

Wooden Stick ◽

Time Of Presentation

Trauma is an important cause of monocular blindness in the developing world. This study aims to determine the demographic profile and visual outcome of cataract surgery among the children with traumatic cataract. It was a prospective and longitudinal study of 189 consecutive children below 16 years who underwent cataract surgery with intra ocular lens (IOL) implantation for traumatic cataract at Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from October 2012 to March 2014. Assessment included visual acuity measurement in the Snellen’s chart or the Cardiff card, anterior segment examination with slit lamp, dilated fundus examination with the help of +20D lens in indirect ophthalmoscope, B-scan ultrasonography of posterior segment and objective and subjective refraction. Follow up was scheduled at first post-operative day, at discharge, one month and three months. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Among 189, majority of them were males (73%) and the average age was 8.8±3.6 years. The time of presentation ranged from 3 days to 8 years (median age two months). Wooden stick was the most common cause of injury (34.4%). The average preoperative visual acuity in logMAR scale was 1.6. The average postoperative visual acuity in logMAR scale was 0.8. Eye injuries with traumatic cataract are associated with significant visual impairment. Cataract surgery with intraocular lens implantation restores vision significantly.

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Primary and Secondary Intraocular Lens Implantation in Congenital Cataract Surgery: A Retrospective Comparative Study of the Visual Outcomes

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr/01/01/00004 ◽

2017 ◽

Vol 1 (1) ◽

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Intraocular Lens ◽

Congenital Cataract ◽

Iol Implantation ◽

Visual Outcomes ◽

Secondary Iol Implantation ◽

Myopic Shift ◽

Congenital Cataract Surgery

Objectives: To compare visual outcomes, principally myopic shift, visual acuity, intraocular pressure and strabismus between primary and secondary intraocular lens (IOL) implantation following congenital cataract surgery. Methods: A retrospective study of the long-term ocular outcomes in primary versus secondary IOL implantation (IOL-I) following congenital cataract surgery was conducted. We analyzed the files of all children with congenital cataract who underwent unilateral or bilateral lensectomy, posterior capsulotomy and anterior vitrectomy followed by primary or secondary IOL-I between 2000 to 2012, at King Abdulaziz University Hospital, Jeddah. Preoperative and postoperative assessment of each operated eye in terms of axial length, refractive errors, strabismus as well as (post IOL-I) intraocular pressure (IOP) and best corrected visual acuity (BC-VA) were collected and analyzed. Results: Data of 26 eyes of 14 patients (9 males, 6 females) was analyzed: 16 (61.5%) eyes underwent lensectomty and anterior vasectomy with primary IOL-I and 10 (38.5%) eyes underwent lumpectomy and anterior vasectomy with secondary IOL-I. Mean age at cataract surgery was 67.53 (± 48.70) months in the group of primary IOL-I versus 5.90 (± 3.72) months in the group of secondary IOL-I; and patients were followed up for 49.33 (± 26.23) versus 86.50 (± 23.36) months, respectively (p=.051). In the secondary IOL-I group, the mean of time from primary lensectomy to IOL-I was 50.44 (± 18.41) months. Last BC-VA showed better outcomes in primary IOL-I group as 10 eyes (83.3%) with good VA versus only 2 eyes (20%) in the secondary IOL-I, (p=0.009). Myopic shift was greater in secondary IOL group 10.86 (± 11.62) versus 0.19 (± 2.38) diopters (D) in primary IOL (p=0.046*); while no significant difference was observed in IOP (p=0.697). No case of isotropic was detected in primary versus 6 cases in the secondary IOL group. Conclusion: Visual outcomes, including visual acuity, strabismus and myopic shift were better in the group of children who underwent primary IOL implantation at age of >2 years, when compared to those with secondary IOL implantation at the age of <2 years, following congenital cataract surgery. However, poor visual acuity in the secondary IOL group was mainly explained by the relatively higher prevalence of eye complications in this group.

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Good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body by external magnetic extraction through a pars plana incision: A case report

10.21203/rs.2.319/v3 ◽

2019 ◽

Author(s):

Zhitao Su ◽

Panpan Ye ◽

Jijian Lin ◽

Xiaodan Huang ◽

Xiaoyun Fang

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Cataract Surgery ◽

Penetrating Trauma ◽

Traumatic Cataract ◽

Visual Axis ◽

Visual Rehabilitation ◽

Pars Plana ◽

Magnetic Extraction

Abstract Background: There is an increasing trend toward performing pars plana vitrectomy and simultaneous cataract extraction in the management of patients with intraocular foreign bodies and traumatic cataracts. Herein, we describe a case of good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body (IVFB) using an external approach. Case presentation: A 44-year-old man presented to our ophthalmology department because of decreased visual acuity after a penetrating trauma to the left eye 2 days earlier. Best-corrected visual acuity (BCVA) was 20/200. An examination revealed a midperipheral self-sealing corneal penetrating wound at the 5 o’clock position, in addition to a mild inflammatory reaction in the anterior chamber. Pupil dilation revealed peripheral anterior and posterior capsular violations, with subcapsular opacity involving the visual axis. A small metallic-like foreign body suspended in the vitreous was confirmed by B-scan ultrasonography and orbital computed tomography. Retinal injury and vitreous hemorrhage were excluded by B-scan ultrasonography and binocular indirect ophthalmoscopy. This IVFB was successfully removed by external magnetic extraction through a pars plana incision. At the 2-week follow-up, the traumatic cataract was partially resolved, and BCVA improved to 20/125. At the 3-month follow-up, the traumatic cataract was mostly resolved, the visual axis was clear under a normal pupil, and BCVA improved to 20/20. Peripheral localized lens opacity was foun

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Nanogel-Facilitated In-Situ Delivery of a Cataract Inhibitor

Biomolecules ◽

10.3390/biom11081150 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1150

Author(s):

Dixa Gautam ◽

Michelle G. Pedler ◽

Devatha P. Nair ◽

Jonathan Mark Petrash

Keyword(s):

Cataract Surgery ◽

Vision Loss ◽

Effective Means ◽

Lens Capsule ◽

Posterior Capsular Opacification ◽

Surgical Removal ◽

Visual Disability ◽

Visual Axis ◽

Number Of Patients ◽

Subsequent Degradation

Cataracts are a leading cause of blindness worldwide. Surgical removal of cataracts is a safe and effective procedure to restore vision. However, a large number of patients later develop vision loss due to regrowth of lens cells and subsequent degradation of the visual axis leading to visual disability. This postsurgical complication, known as posterior capsular opacification (PCO), occurs in up to 30% of cataract patients and has no clinically proven pharmacological means of prevention. Despite the availability of many compounds capable of preventing early steps in PCO development, there is currently no effective means to deliver such therapies into the eye for a suitable duration. To model a solution to this unmet medical need, we fabricated acrylic substrates as intraocular lens (IOL) mimics scaled to place into the capsular bag of the mouse lens following a mock-cataract surgery. Substrates were coated with a hydrophilic crosslinked acrylate nanogel designed to elute Sorbinil, an aldose reductase inhibitor previously shown to suppress PCO. Insertion of the Sorbinil-eluting device into the lens capsule at the time of cataract surgery resulted in substantial prevention of cellular changes associated with PCO development. This model demonstrates that a cataract inhibitor can be delivered into the postsurgical lens capsule at therapeutic levels.

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Determinants of posterior capsular opacity after cataract surgery: a cross-sectional study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190024 ◽

2019 ◽

Vol 7 (2) ◽

pp. 577

Author(s):

Pratima Sahu ◽

Amit Kumar Mishra

Keyword(s):

Cataract Surgery ◽

Average Duration ◽

Extraction Procedure ◽

Cataract Extraction ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Posterior Capsular Opacification ◽

Cross Sectional ◽

Posterior Capsular Opacity ◽

Patient Department

Background: Posterior capsular opacification (PCO) which is also known as “after cataract” or “secondary cataract”, is the most common complication of cataract surgery, with an incidence of 20-50%. The current study was conducted in a tertiary hospital of Odisha with an objective to find out the determinants of PCO among patients with defective vision attending the outdoor patient department of Ophthalmology.Methods: A hospital based descriptive study was conducted among the patients attending the ophthalmology out patient department of a tertiary hospital of Odisha. The detail history regarding the type of surgical procedure used for cataract extraction and the type of Intra Ocular Lens (IOL) implanted, duration of post-operative period was collected from the available documents and ophthalmic examination of the participants.Results: In the present study, 184 participants were included and examined. Fifty percent of the participants had undergone conventional extra capsular cataract extraction procedure. In 86.95% participants, the IOL used was Poly Methyl Methacrylate lens (PMMA). In 26.08% of the participants the development of PCO was within 12 to 36 months of cataract surgery. The average duration of PCO development recorded for participants <20 years was 3 months.Conclusions: Most of the participants included in the study with PCO had undergone conventional ECCE surgery, implanted PMMA lens, IOL with round edge and had a duration of 12-36 months between cataract surgery and PCO development. The average duration of PCO development is less among younger participants which gradually increases with increase in age.

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A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

10.36106/gjra/7413860 ◽

2020 ◽

pp. 173-176

Author(s):

Kinjal Rathod ◽

Kinjal Trivedi ◽

Snehal Nayi ◽

Somesh Aggarwal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Nd:Yag Laser ◽

Visual Outcome ◽

Posterior Capsular Opacification ◽

P Value ◽

Small Incision Cataract Surgery ◽

Common Procedure ◽

Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

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Cataract Surgery and Uveitis

Annals of King Edward Medical University ◽

10.21649/akemu.v9i3.1332 ◽

2016 ◽

Vol 9 (3) ◽

Author(s):

Mumtaz Hussain ◽

Muhammad Moin ◽

Nazir Ahmad Aasi ◽

Muhammad Waqas ◽

Jawaid Mughal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

General Hospital ◽

Cataract Extraction ◽

Extracapsular Cataract Extraction ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

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Deep Anterior Lamellar Keratoplasty followed by Toric Lens Implantation for the Treatment of Concomitant Anterior Stromal Diseases and Cataract

Ophthalmology Point of Care ◽

10.5301/oapoc.0000008 ◽

2017 ◽

Vol 1 (1) ◽

pp. oapoc.0000008 ◽

Cited By ~ 1

Author(s):

Vincenzo Scorcia ◽

Andrea Lucisano ◽

Vincenzo Savoca Corona ◽

Valentina De Luca ◽

Adriano Carnevali ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Cataract Surgery ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Toric Iol ◽

Iol Implantation ◽

Anterior Lamellar Keratoplasty ◽

Topographic Astigmatism

Purpose To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) followed by phacoemulsification and toric intraocular lens (IOL) implantation for the treatment of concomitant stromal disease and cataract. Methods In this retrospective non-comparative interventional case series, ten eyes affected by stromal disease and cataract underwent DALK followed by phacoemulsification with toric IOL implantation after a minimum period of 5 months from complete suture removal. In each case, topographic astigmatism, refraction, visual acuity, and endothelial cell density were recorded before DALK and 1, 6, and 12 months after cataract surgery. In addition, IOL rotation was evaluated using anterior segment optical coherence tomography. Results Big-bubble DALK was performed in all eyes but one that received manual dissection. Topographic astigmatism averaged 5.6 ± 2.2 diopters (D) after suture removal; refractive astigmatism decreased to 0.55 ± 0.61 D as early as one month after cataract surgery and did not change substantially throughout the follow-up period. In all patients, one month after phacoemulsification uncorrected and best spectacle-corrected visual acuity were, respectively, ≥20/40 and ≥20/25 with a residual spherical equivalent of 0.00 ± 0.84 D. At the latest follow-up visit, in all cases the IOL rotation was ≤5 degrees from the intended position and the endothelial cell loss within 8.5%. No complications were recorded. Conclusions DALK followed by phacoemulsification with toric IOL implantation optimizes visual and refractive outcomes in patients with concomitant stromal disease and cataract. In comparison with a combined procedure, the sequential approach offers better predictability of the postoperative refraction in the absence of an increased risk of complications.

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