title: The influence of surgery and intraocular lens implantation timing on visual outcome in traumatic cataract.
abstract: OBJECTIVE
  To compare the visual outcome of primary versus secondary traumatic cataract extraction and primary versus secondary intraocular lens (IOL) implantation.
  
  
  METHODS
  The medical charts of consecutive patients who developed cataract following open and closed-globe injuries and were referred to our institute were reviewed. The best-corrected visual acuity of the patients who underwent primary and secondary cataract extraction and those with primary and secondary IOL implantation was assessed at presentation and at the end of the follow-up.
  
  
  METHODS
  Sixty-nine eyes of 69 patients developed cataract after being involved in ocular trauma. Forty-five eyes had open-globe injury and 24 had closed-globe injury. The right eye was involved in 26 injuries and the left in 43.
  
  
  RESULTS
  Best-corrected visual acuity (BCVA) of 20/40 or better was not statistically associated with the type of cataract extraction (extracapsular versus phacoemulsification) (in open-globe injury p = 0.181 and in all p = 0.662) and placement of anterior or posterior IOL (in open-globe injury p = 0.196 and in all p = 0.114). The timing of surgery (as immediate surgery or later as a second surgery) and the timing of intraocular lens implantation (during the extraction of the cataract or later in a secondary procedure) were not statistically associated with BCVA of 20/40 or better (in open-globe injury p = 0.322 and 0.381 in all p = 0.460 and 0.450, respectively). Irreversible amblyopia in children was a statistically significant factor for this visual acuity both in patients with open-globe injury (p = 0.036) and in all patients (p < 0.001).
  
  
  CONCLUSIONS
  In traumatic cataract, the visual outcome did not differ between primary and secondary cataract extraction and between primary and secondary IOL implantation in adults. In the amblyogenic age, primary surgery with IOL implantation should be preferred.
authors.affiliation: Department of Ophthalmology, Western Galilee-Nahariya Medical Center, Nahariya, Israel. shimon.rumelt@naharia.health.gov.il
authors.forename: Shimon
authors.initials: S
authors.lastname: Rumelt
authors.forename: Uri
authors.initials: U
authors.lastname: Rehany
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology; D002386:Cataract / Q000209:etiology / Q000503:physiopathology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000601:surgery*