title: Epidemiology and intermediate-term outcomes of open- and closed-globe injuries in traumatic childhood cataract.
abstract: OBJECTIVE
  To study epidemiology and intermediate-term outcomes of open- and closed-globe injuries (CGI) in traumatic childhood cataract.
  
  
  METHODS
  In this retrospective interventional case series, demographic parameters and history including type of injury of 57 children younger than 16 years with traumatic cataract were recorded; ocular examination included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and posterior segment evaluation. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Main surgical outcomes at 6 months comprised BCVA, residual refractive spherical error (SE), and postoperative complications, namely visual axis opacification (VAO) and amblyopia.
  
  
  RESULTS
  Bow and arrow was the most common causal agent. Open-globe injury (OGI) was 3 times more frequent than CGI. There was a significant visual gain from baseline in both groups after cataract surgery (p<0.001); residual SE was greater in OGI (1.6 ± 0.95 SD) compared to blunt trauma (0.8 ± 0.55 SD; p = 0.001). Incidence of corneal scarring, iris distortion, posterior synechiae, and intraoperative posterior capsular tear was greater with OGI (p<0.05). A total of 86% of patients were rehabilitated with a primary/secondary IOL. Single-piece IOL implantation rate (p = 0.004) was significantly greater in CGI, with no statistical difference for in-the-bag IOL (p = 0.053) and IOL implantation rate (p = 0.16). Final BCVA was significantly better for in-the-bag IOL implantation compared to sulcus fixation. Postoperative complications included amblyopia (51%) and VAO (12%).
  
  
  CONCLUSIONS
  Bow and arrow injury caused the maximum cases of traumatic cataract; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in pediatric traumatic cataracts.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Khokhar
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.forename: Rohit
authors.initials: R
authors.lastname: Yogi
authors.forename: Varun
authors.initials: V
authors.lastname: Gogia
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000453:epidemiology* / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery