Jinagal Jitender, Gupta Gaurav, Gupta Parul C, Yangzes Sonam, Singh Rishiraj, Gupta Rohit, Ram Jagat
Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Eur J Ophthalmol. 2019 Jan;29(1):23-27. doi: 10.1177/1120672118757657. Epub 2018 Apr 3.
: To report visual outcomes and risk factors of pediatric traumatic cataracts in a tertiary care referral center in northern India.
: We analyzed medical records of traumatic cataracts in the pediatric age group (1-15 years) operated for cataract surgery with or without posterior chamber intraocular lens implantation with or without primary posterior capsulotomy with anterior vitrectomy between 2004 and 2012. Causative agents, types of trauma, demographic factors, surgical interventions, complications, and visual acuity were recorded and compared among different groups.
: A total of 147 children were documented to have undergone cataract surgery for traumatic cataract in the study period, male-to-female ratio being approximately 5:1. Mean age was 7.67 ± 3.30 years (range, 1-15 years). Type of primary insult was penetrating injury in 100 (68%) patients and blunt trauma in 47 (32%) patients. Mean interval between injury and cataract surgery in penetrating injury cases was 3.84 ± 7.05 months and in the blunt injury cases was 6.28 ± 11.13 months. Preoperatively, only 110 patients were cooperative for visual acuity. Out of them, none had vision better than 6/18 and only 21 patients (19.9%) had vision of ≥6/60. Visual acuity of 6/18 or better (was considered good visual outcome) was achieved by 87.9%, 97.3%, and 97.9% at 1, 6, and 36 months, postoperatively. Eyes which underwent primary posterior capsulotomy and anterior vitrectomy during cataract surgery showed statistically better visual outcome than those without it.
: Phacoaspiration with posterior chamber intraocular lens implantation along with primary posterior capsulotomy and anterior vitrectomy and timely introduction of amblyopia therapy helped in gaining good visual outcome in pediatric traumatic cataract patients irrespective of the age of presentation and the type of injury.
报告印度北部一家三级医疗转诊中心小儿外伤性白内障的视力预后及危险因素。
我们分析了2004年至2012年间接受白内障手术的小儿年龄组（1至15岁）外伤性白内障的病历，这些手术包括有或无后房型人工晶状体植入、有或无一期后囊切开联合前部玻璃体切割术。记录并比较不同组别的致病因素、外伤类型、人口统计学因素、手术干预、并发症及视力情况。
在研究期间，共有147名儿童因外伤性白内障接受了白内障手术，男女比例约为5:1。平均年龄为7.67±3.30岁（范围1至15岁）。主要损伤类型为穿透伤100例（68%），钝挫伤47例（32%）。穿透伤病例受伤至白内障手术的平均间隔时间为3.84±7.05个月，钝挫伤病例为6.28±11.13个月。术前，只有110例患者能配合视力检查。其中，视力优于6/18的无一人，只有21例患者（19.9%）视力≥6/60。术后1个月、6个月和36个月时，视力达到6/18或更好（被视为良好视力预后）的比例分别为87.9%、97.3%和97.9%。白内障手术期间接受一期后囊切开联合前部玻璃体切割术的眼睛，其视力预后在统计学上优于未接受该手术的眼睛。
超声乳化联合后房型人工晶状体植入、一期后囊切开联合前部玻璃体切割术以及及时开展弱视治疗，有助于小儿外伤性白内障患者获得良好的视力预后，无论其就诊年龄及损伤类型如何。
