Management of traumatic cataracts

Poster Details

First Author: FaniAkritidou GREECE

Co Author(s):    Maria Karafyloglou   Dimitrios Mpakas   Vlasios Antoniou   Vasilios Kolokoutsas   Damianos Mposvelis   Dimitrios Karamanis

Abstract Details

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Purpose:

To evaluate the incidence of traumatic cataracts and to review the visual outcome of traumatic cataracts operated at the General Hospital of Kavala – Greece, with the purpose to making recommendations for improved outcome.

Setting:

: General Hospital of Kavala – Greece

Methods:

All patients operated at the General Hospital of Kavala, Greece, between 2009 and 2013 with traumatic cataract were reviewed retrospectively to study the incidence of this type of cataract and to determine visual outcome and main causes of poor visual outcome, using data and information obtained from the operation register and case notes of patients.

Results:

During the investigated interval (1/2009-10/2013) 32 patients operated for cataract following an ocular trauma, age range 42 to 71 years, were reviewed. The male-to-female ratio in these cases is approximately 5:1. The cases of traumatic cataract tend to increase during these years. Cataract formation is commonly observed as a result of direct penetration of the crystalline lens by a foreign object or by blunt trauma to the globe or adnexa, creating a ""shock wave"" within the eye. In our study causes of traumatic cataract for male patients included wood and metal splinters in 15 cases, road traffic accident in 8 cases and 4 cases related to eye injuries during a fight. For the female patients the cause of traumatic cataract was road traffic accidents. Consequently, the most common cause for all the cases is work-related eye injuries. The retrospective analysis of the postoperative course showed an apparent functional improvement in the simple cases (best corrected post operative visual acuity of ≥4/10), while in 8 cases of aggravated traumatic cataracts we had poorer functional results (blindness or BCVA≤1/10). Cause of poor post operative visual acuity included cornea opacity 6 cases and retinovitreous late complications/retinal detachment in 2 of the cases.

Conclusions:

During the last years as the profile of greek society has changed – the number of farmers and manual workers has significantly increased. This is associated to the increase of incidence of ocular trauma and the increased incidence of traumatic cataract, the most common cause of which is wood and iron splinters. Surgery for traumatic cataracts is a potentially complex procedure. Clinically, traumatic cataracts may be difficult to thoroughly assess due to the presence of other significant ocular damage. Frequently, surgery involves surprises regarding the integrity of the posterior capsule and zonular structure. Careful preoperative evaluation and ophthalmic imaging using ultrasound technologies may therefore give the surgeon great advantage when planning surgery. Useful vision can be restored in a many cases of traumatic cataracts through surgery, although sight-limiting complications, which may be related to the severity of the trauma may be present. The need for adequate health education to prevent ocular injuries and preoperative diagnosis of associated posterior segment complications that may prevent optimal post-operative visual acuity is also noted. FINANCIAL INTEREST: NONE"