Faculty Collaboration Database

Visual Outcomes and Complications After Lensectomy for Traumatic Cataract in Children. JAMA Ophthalmol 2021 Jun 01;139(6):647-653

Date

05/07/2021

Pubmed ID

33956055

Pubmed Central ID

PMC8209594

DOI

10.1001/jamaophthalmol.2021.0980

Scopus ID

2-s2.0-85105942884 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

IMPORTANCE: The Pediatric Eye Disease Investigator Group Cataract Registry provides a multicenter assessment of visual outcomes and complications after lensectomy for traumatic pediatric cataract.

OBJECTIVE: To report visual acuity (VA) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months after lensectomy for traumatic cataract among children younger than 13 years at the time of surgery.

DESIGN, SETTING, AND PARTICIPANTS: From June 18, 2012, to July 8, 2015, 1266 eyes of 994 children from 33 pediatric eye care practices seen within 45 days after lensectomy were enrolled in a multicenter, prospective observational registry. Of these, 74 eyes of 72 participants undergoing lensectomy for traumatic cataract were included in a cohort study. Follow-up was completed by November 2, 2015, and data were analyzed from March 20, 2018, to July 7, 2020.

EXPOSURES: Lensectomy after ocular trauma.

MAIN OUTCOMES AND MEASURES: Best-corrected VA from 9 to 15 months after lensectomy for traumatic cataract (for those 3 years or older) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months.

RESULTS: Of 994 participants in the registry, 84 (8%) had traumatic cataract. The median age at lensectomy for 72 participants examined within 15 months after surgery was 7.3 (range, 0.1-12.6) years; 46 (64%) were boys. An intraocular lens was placed in 57 of 74 eyes (77%). In children 3 years or older at outcome, the median best-corrected VA was 20/250 (range, 20/20 to worse than 20/800) in 6 eyes with aphakia and 20/63 (range, 20/20 to 20/200) in 26 eyes with pseudophakia. Postoperative visual axis opacification was reported in 18 of 27 eyes with pseudophakia without primary posterior capsulotomy (15-month cumulative proportion, 77%; 95% CI, 58%-92%). The cumulative proportion with strabismus was 43% (95% CI, 31%-58%) in 64 participants with ocular alignment data; exotropia was present in 14 of 23 participants (61%). The cumulative proportion with glaucoma was 6% (95% CI, 2%-16%).

CONCLUSIONS AND RELEVANCE: Trauma was not a common cause of pediatric cataract requiring surgery. For children with traumatic cataract, substantial ocular morbidity including permanent vision loss was found, and long-term eye and vision monitoring are needed for glaucoma, strabismus, and capsular opacification.

Author List

Writing Committee for the Pediatric Eye Disease Investigator Group (PEDIG), Bothun ED, Repka MX, Dean TW, Gray ME, Lenhart PD, Li Z, Morrison DG, Wallace DK, Kraker RT, Cotter SA, Holmes JM

Author

Alexander Joseph Khammar MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cataract
Cataract Extraction
Child
Cohort Studies
Eye Injuries
Female
Follow-Up Studies
Glaucoma
Humans
Lens Implantation, Intraocular
Male
Postoperative Complications
Pseudophakia
Retrospective Studies
Strabismus