Case Reports

Bilateral traumatic cataract in a paediatric case

Case Report Details

First Author: M.Dudau ROMANIA

Co Author(s):    M. Dudau   C. Tataru   A. Mosu   S. Prodescu   C. Tataru   D. Fumarel     

Abstract Details

Purpose:

The aim is to present our surgical outcome in a bilateral traumatic cataract in a 10 years old patient.

Setting:

Cataract Department, Emergency Eye Clinical Hospital, Bucharest, Romania

Report of Case:

A 10-year-old male with no past medical history presented for penetrating injury of the right eye and blunt trauma of the left eye after fireworks explosion. The patient was previously referred to another hospital where the corneal laceration was sutured. He presented after 2 weeks following trauma in our emergency department with hand motion vision in both eyes and ocular hypertension in left eye. The slit lamp examination revealed corneal edema, hyphema, multiple tears in the iris sphincter, posterior synechia and white cataract in both eyes. B-scan evaluation was performed with signs of vitreous hemorrhage in the left eye. We performed a multi-step surgical approach. Firstly, the left eye was addressed due to high intraocular pressure therefore cataract extraction and anterior vitrectomy was performed, followed 3 days after by the right eye. After 2 months post-cataract extraction, we performed a 3-piece posterior chamber intraocular lens (PCIOL) implantation with scleral fixation in both eyes. Postoperative evolution was uneventful, with BCVA of 0.4 in both eyes and no dislocation of the lens or other complications during 6-month observation period.

Conclusion/Take Home Message:

Traumatic cataracts are the most common cause for severe vision loss in paediatric patients after an open globe injury and proper management is essential for good visual outcomes. The decision to perform wound repair with cataract extraction and lens implantation versus a staged approach depends on various factors, including the nature of the injury, cornea visibility and risk of infection. Secondary implantation of a lens allows more accurate measurements and may lower the risk of infection, but it is an additional surgery with anesthesia exposure in paediatric patients.

Financial Disclosure:

None