title: Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India.
abstract: OBJECTIVE
  To describe preoperative factors, long-term (>3 years) postoperative outcome and cost of traumatic cataracts in children in predominantly rural districts of western India. Subjects : Eighty-two traumatic cataracts in 81 children in a pediatric ophthalmology department of a tertiary eye-care center.
  
  
  METHODS
  Traumatic cataracts operated in 2004-2008 were reexamined prospectively in 2010-2011 using standardized technique. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded.
  
  
  METHODS
  Data analysis done by using SPSS (Statistical package for social sciences) version 17.0 We have used Chi-square test, Fisher's exact test, paired t-test to find the association between the final vision and various parameters at 5% level of significance; binary logistic regression was performed for visual outcome ≥6/18 and ≥6/60.
  
  
  RESULTS
  The children were examined in a 3-7 year follow-up (4.35 ± 1.54). Average age at time of surgery was 10.4 ± 4.43 years (1.03 to 18). Fifty (61.7%) were boys. Forty (48.8%) were blunt and 32 (39%) were sharp trauma. The most common cause was wooden stick 23 (28.0%) and sharp thorn 14 (17.1%). Delay between trauma and presentation to hospital ranged from same day to 12 years after the injury with median of 4 days. The mean preoperative visual acuity by decimal notation was 0.059 ± 0.073 and mean postoperative visual acuity was 0.483 ± 0.417 (P < 0.001). Thirty-eight (46.3%) had best corrected visual acuity (BCVA) ≥6/18 and 51 (62.2%) had BCVA ≥ 6/60. In univariable analysis, visual outcome (≥6/18) depended on type of surgery (P = 0.002), gender (P = 0.028), and type of injury (P = 0.07)-sharp trauma and open globe injury had poorer outcomes; but not on age of child, preoperative vision, and type of surgeon. On multivariable binary logistic regression, only gender was significant variable. Of the 82 eyes, 18 (22%) needed more than one surgery. The parents spent an average of Rs. 2250 ($45) for the surgery and 55 (66.4%) were from lower socio-economic class.
  
  
  CONCLUSIONS
  The postoperative visual outcomes varied and less than half achieved ≥ 6/18.
authors.affiliation: Lions NAB Eye Hospital, Miraj, Sangli District, Maharashtra, India.
authors.forename: Parikshit
authors.initials: P
authors.lastname: Gogate
authors.forename: Mohini
authors.initials: M
authors.lastname: Sahasrabudhe
authors.forename: Mitali
authors.initials: M
authors.lastname: Shah
authors.forename: Shailbala
authors.initials: S
authors.lastname: Patil
authors.forename: Anil
authors.initials: A
authors.lastname: Kulkarni
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002386:Cataract / Q000453:epidemiology* / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012424:Rural Population; D013997:Time Factors; D014792:Visual Acuity