Intraocular lens implantation for traumatic cataract in children in East Africa.
OBJECTIVE
To review the visual outcomes and complications after intraocular lens (IOL) implantation in children with traumatic cataract in sub-Saharan Africa, where contact lenses for unilateral aphakia are impractical in most patients.


METHODS
PCEA Kikuyu Eye Unit, Nairobi, Kenya, East Africa.


METHODS
All children younger than 16 years having IOL implantation for traumatic cataract between February 1993 and December 1998 (215 eyes) were retrospectively reviewed. Complications and visual outcomes were evaluated.


RESULTS
The study group comprised 147 boys and 68 girls. The median interval between injury and cataract surgery was 8 weeks. The most common causes of injury were stick (36.3%) and thorn (10.7%). Extracapsular cataract extraction with IOL implantation was performed in all patients. The most frequent early complication was fibrinous uveitis in 110 eyes (51.2%). One hundred sixty-seven eyes (77.7%) had 1 month or more follow-up. Of those, 108 eyes (64.7%) had a best corrected visual acuity of 20/60 or better. Twenty-one eyes (12.6%) had a visual acuity of worse than 20/200, with the most common causes being amblyopia (9/21) and retinal detachment (5/21). Amblyopia was found in 42 of 108 (38.9%) children aged 8 years or less at the time of injury. Eyes with the IOL in the capsular bag were significantly less likely to require subsequent capsulotomy (P <.01) during the 2-year follow-up.


CONCLUSIONS
The results indicate that posterior chamber IOLs can be safely implanted by experienced surgeons in most children older than 2 years with traumatic cataract and should be the standard of care throughout the world.
Gradin
D
D
PCEA Kikuyu Eye Unit, East Africa, Nairobi, Kenya.
Yorston
D
D
D000293:Adolescent; D000328:Adult; D000351:Africa, Eastern; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D007910:Lenses, Intraocular; D008297:Male; D008689:Methacrylates; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity
D008689:Methacrylates; C005044:hydroxyethyl methacrylate; D019904:Polymethyl Methacrylate