Predictors of visual outcome in traumatic cataract

Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.

EXPERIMENTAL STUDY ON THE CORNEAL ENDOTHELIUM OF TRAUMATIC CATARACT

The cell morphology of corneal endothelium in 84 mice with experimental traumatic cataract was investigated with stained corneal buttons. In the experimental group, the boundaries between adjacent corneal endothelial cells were significantly distorted, some cell boundaries manifested degenerative changes that led to coalescence of the cells. The mean density and mean area of endothelial cells of the controls showed significant difference from those of the experimental group during the 12 weeks of observ...

Pediatric Traumatic Cataracts at a Tertiary Eye Center in Indonesia

Background: Traumatic cataract is the leading cause of significant monocular visual impairment in children. The cause of this type of cataract is preventable penetrating or blunt ocular injury. Lens extraction can improve the visual acuity but it also depends on the extent of the injury to other ocular structures. Objective: To describe the features of pediatric traumatic cataract presenting at a tertiary eye center in Indonesia. Methods: This study is a descriptive study and the data were collected retrospectively from the medical records of the patients who were diagnosed as pediatric traumatic cataract over the period of January 1st 2019 to December 31st 2019. Demographic data, trauma characteristics, clinical features, management, and pre- and post-operative Best Corrected Visual Acuity (BCVA) were reviewed retrospectively. Results: A total of 37 patients were diagnosed as pediatric traumatic cataract. Among these patients, 78.38% were boys, with the mean age of 9.14 ± 3.77 years old. Open globe injury was the mechanism of injury for 54.05% patients. Besides lens aspiration, additional procedures were membranectomy, anterior vitrectomy, primary posterior capsulotomy, and synechiolysis. Eighty-one percent patients had unilateral blindness preoperatively and 23.80% patients still had unilateral blindness on three months of follow-up. Conclusion: In pediatric patients, traumatic cataract occurred predominantly in boys while playing outside the house. The children who had ocular trauma still have the risk of blindness even after the surgery. Trauma prevention and avoidance by adult supervision when children engage in outdoor play activity are necessary.

Posterior Chamber IOL Implantation in Traumatic Cataract with Injured Complications

Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.

AN EXPERIMENTAL STUDY OF THE TUMOUR NECROSIS FACTOR LEVELSIN AQUEOUS HUMOR AFTER TRAUMATIC CATARACT AND INTRAOCULAR LENS IMPLANTATION

Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabbits,and discusses the effect of TNF on postoperative anterior ocular inflammation. Methods. Twenty seven pigmented rabbits were divided into three groups: for the first group, the IOL were placed in the capsular bag after traumatic cataract extraction; for the second, the Extracapsular cataract extraction without IOL implantation; and for the third, the control group without surgical intervention. On the 1st, 3rd, 7th and 14th day postoperatively, aqueous humor samples were obtained. A modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were studied by means of analysis of variance in SAS software. Result. The TNF level was increased in aqueous humor and reached its maximum on the 1st postoperative days after traumatic cataract extraction and PC IOLs implantation, and the TNF levels are significantly higher (P<0 05) on the 1st, 3rd, 7th and 14th day postoperatively in traumatic cataract extraction and PC IOL implanted group than that in the non surgical intervention group and extracapsular cataract extraction group. Conclusions. The increase of TNF levels had a close relationship with presence of the IOL itself which induces the secretion of TNF. This suggested that TNF as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after traumatic cataract extraction and IOL implantation.

Technique of using Cionni-modified capsular tension ring in the management of severely traumatic lens subluxation

AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.

A Clinical Analysis of 120 Cases with Traumatic Cataract Treated by Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation

Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.

Intralenticular metallic foreign body: a case report

A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.

Management and treatment of bizarre open globe trauma in three steps:a case report

This is a case presentation of a very bizarre open globe trauma with anterior segment foreign body-fishing hook stuck in the cornea and iris. Complications due to this kind of eye trauma might be very hazardous and with serious impact on visual function. We are representing our approach and experience of three step management of this kind of eye injury: first-extract the foreign body, close and reconstruct the eyeball, second-fight inflammation, and third-restore the visual function by cataract surgery.

Safety and efficacy of trans-scleral glued intraocular lens implantation

Background:The commonly used intraocular lens(IOL)implantation modalities when there is a rent in a posterior capsule or lack of posterior capsular support includes iris fixated IOL,anterior chamber(AC)IOL,sutured and suture less trans-scleral fixated IOL.This work was planned to evaluate the safety and efficacy of trans-scleral glued IOL implantation.Methods:Retrospective study was undertaken with 28 patients of glued IOL fixation,performed by a single surgeon over a period of 4 years.Relevant pre-operative and post-operative data including visual acuity,intraocular pressures,associated ocular conditions and complications were collected and statistically analyzed.Results:The mean age of males in our study group was 39.1±4.6 years and mean age of females were 37.9±7.5 years.Glued IOL was implanted in 13 eyes with traumatic cataract with subluxation of 46.4%.The most common associated ocular condition was found to be a penetrating ocular trauma with corneal tear in three patients(10.6%).The mean pre-operative and post-operative Log MAR acuity was found to be 1.18 and 0.55 respectively,which was found to be statically significant with P value of 0.00.Twenty five out of 28 patients(89%)of the study population had no postoperative complications.Conclusions:Glued IOL implantation technique has 89%of success rate and statistically significant improvement in visual acuity with no significant change in intraocular pressure.