gms | German Medical Science

Purpose: To analyze clinical outcomes and the results of new elaborate techniques of traumatic pediatric cataract extraction with in-the-bag foldable IOL implantation after penetrating injuries.

Materials and methods: The main features of operative elaborated techniques were: 1- In swelling cataracts with anterior capsule tears: endocapsular cataract extraction with bagal IOL implantation by injector through the wound of the anterior capsule, IOL rotation for arrangement of haptic elements in area of preserved anterior capsule, additional partial anterior capsulorhexis in the optic zone after implantation. 2- In semi-resolved cataracts, complicated by anterior and posterior synechias: synechiotomy were performed only in exocentric area, small diameter anterior capsulorhexis away from synechias formation sites, cataract phakoaspiration, in-the-bag foldable IOL implantation through small capsule-rhexis/tomy, which enlarged after implantation. Preoperative damage structures, intraoperative and postoperative complications were analyzed for all eyes. 41 eyes- 41 children (mean age 10,02±3 years; range 5 to 17 years) with monocular traumatic cataract after penetrating injuries have been operated. Patients were followed for an average of 9±6 months. In majority of cases (46,0%) the traumatic cataracts were swelling, semi-resolved (30,0%) and total (24,0%) were also observed. Traumatic cataracts were complicated by: corneal scars, anterior capsule tears in all cases, anterior and posterior synechias (63,7%), pupil sphincter rupture (26,0%), iridodyalisis (11,7%). Preoperative visual acuity ranged from light perception to 0,1 in most patients, who underwent surgery between 1 week and one year after the trauma.

Results and discussion: Foldable IOL Acrysof were implanted in the capsular bag in all cases. In patients with iris defects closed iridoplasty were performed. No complications were noted intraoperative. In remote terms of observations bagal IOL fixation were noted stable. The functional results of post-traumatic pseudophakia have shown improvement of visual acuity in early and long term of observation, in all children it increased up to 0,3 -1,0.

Conclusion: In majority of children with complicated traumatic cataracts were safely rehabilitated with in-the-bag IOL implantation. High visual acuity (0,3-1,0) were improved in all cases, which provides satisfactory results and allows to restore the visual functions of traumatized eye.