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Soleimani M, Cheraqpour K, Salari F, Fadakar K, Habeel S, Baharnoori SM, Banz S, Tabatabaei SA, Woreta FA, Djalilian AR. All about traumatic cataracts: narrative review. J Cataract Refract Surg 2024; 50:760-766. [PMID: 38350230 PMCID: PMC11196203 DOI: 10.1097/j.jcrs.0000000000001424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024]
Abstract
Ocular trauma is an important cause of monocular blindness worldwide. Injury to the lens after blunt or penetrating trauma is common and can result in vision impairment. Selecting the most appropriate therapeutic approaches depends on factors such as patients' age, mechanism of trauma, and underlying clinical conditions. Early management, especially within childhood, is essential because of the difficulties involved in examination; anatomical variations; as well as accompanying intraocular inflammation, amblyopia, or vitreoretinal adhesions. The objective of this study was to provide a comprehensive review of the epidemiology and clinical management of traumatic cataract, highlighting the significance of accurate diagnosis and selection of the optimal therapeutic approach.
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Affiliation(s)
- Mohammad Soleimani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Fadakar
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samer Habeel
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Mahbod Baharnoori
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Soraya Banz
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- University of Edinburgh, UK
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fasika A. Woreta
- Wilmer Eye Institute, Johns Hopkins Medical Institute, Baltimore, MD, USA
| | - Ali R. Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Li C, Chen X, Ke X, Cheng Y, Zhang Q, Liao X, Xia H, Shi T, Jin C, Huang Y, Chen H. Comparison of the effectiveness of different corneal curvature measurement methods for IOL implantation in traumatic aphakic eyes with corneal injury. Int Ophthalmol 2024; 44:248. [PMID: 38907133 DOI: 10.1007/s10792-024-03172-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 06/15/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND/AIM To assess the refractive outcomes of secondary intraocular lenses (IOL) in patients with traumatic aphakic eyes with corneal penetrating injury and compare different corneal curvature measurement methods. METHODS Patients with unilateral penetrating eye injuries underwent corneal wound repair and cataract extraction, followed by secondary IOL implantation. Corneal curvature measurements were taken on the contralateral healthy eye (Group A), from the affected eye before removing corneal sutures (Group B), or after suture removal (Group C). The refractive outcomes were compared among the three groups. RESULTS The study included 261 eyes. The Mean Absolute Error (MAE) in Group C (0.99 ± 0.85 D) was significantly smaller than that in Group A (1.87 ± 1.71 D) and Group B (1.37 ± 1.20 D) (both P < 0.001). Moreover, the percentage of eyes with IOL prediction errors within ± 0.50 D in Group C (40%) was higher than that in group A (21.7%) (OR = 2.364, 95%CI: 1.272-4.392, P = 0.006) and group B (28.0%) (OR = 1.714, 95%CI: 0.948-3.099, P = 0.073), and the percentage of eyes with IOL prediction errors within ± 1.0 D in Group C (90.9%) was higher than that in group A (67.9%) (OR = 4.758, 95%CI: 2.131-10.626, P < 0.001) and group B (75.0%) (OR = 3.370, 95%CI: 1.483-7.660, P = 0.003) as well. CONCLUSIONS In traumatic aphakic eyes with corneal sutures, IOL power calculation based on the corneal curvature of the injured eye after removing the corneal sutures yields the best refractive outcomes.
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Affiliation(s)
- Cuilian Li
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Xiaolin Chen
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Xixuan Ke
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Yinglin Cheng
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Qi Zhang
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Xulong Liao
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Honghe Xia
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Tingkun Shi
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Chuang Jin
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Yuqiang Huang
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, China.
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Sen P, Shah C, Sen A, Jain E, Mohan A. Primary versus secondary intraocular lens implantation in traumatic cataract after open-globe injury in pediatric patients. J Cataract Refract Surg 2018; 44:1446-1453. [DOI: 10.1016/j.jcrs.2018.07.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/27/2018] [Accepted: 07/28/2018] [Indexed: 11/25/2022]
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Shah M, Shah S, Gupta L, Jain A, Mehta R. Predictors of visual outcome in traumatic cataract. World J Ophthalmol 2014; 4:152-159. [DOI: 10.5318/wjo.v4.i4.152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/21/2014] [Accepted: 09/24/2014] [Indexed: 02/06/2023] Open
Abstract
Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.
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Shah M, Shah S, Upadhyay P, Agrawal R. Controversies in traumatic cataract classification and management: a review. Can J Ophthalmol 2014; 48:251-8. [PMID: 23931462 DOI: 10.1016/j.jcjo.2013.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/21/2013] [Accepted: 03/15/2013] [Indexed: 12/25/2022]
Abstract
Traumatic cataract is one of the important causes of blindness after ocular trauma, either open or close globe. Visual outcome is unpredictable because it is not only lens that decides visual outcome. There is no standard classification, investigation, or treatment guidelines for the same. There are controversies regarding predictive models. We would like to highlight these controversies and try to reach certain guidelines that may help clinicians to manage traumatic cataracts.
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Affiliation(s)
- Mehul Shah
- Drashti Netralaya, Dahod, Gujarat, India.
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Xu YN, Huang YS, Xie LX. Pediatric traumatic cataract and surgery outcomes in eastern China: a hospital-based study. Int J Ophthalmol 2013; 6:160-4. [PMID: 23638416 DOI: 10.3980/j.issn.2222-3959.2013.02.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/05/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma: closed-globe (n=26) or open-globe (n=91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision. CONCLUSION Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.
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Affiliation(s)
- Ying-Nan Xu
- Weifang Medical University, Weifang 261053, Shandong Province, China ; Shandong Eye Institute, Qingdao 266071, Shandong Province, China
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Shah M, Shah S, Shah S, Prasad V, Parikh A. Visual recovery and predictors of visual prognosis after managing traumatic cataracts in 555 patients. Indian J Ophthalmol 2011; 59:217-22. [PMID: 21586844 PMCID: PMC3120243 DOI: 10.4103/0301-4738.81043] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM The aim was to evaluate the visual recovery after managing traumatic cataracts and determine the predictors of a better visual prognosis. MATERIALS AND METHODS This was a prospective study. We enrolled patients with specific inclusion criteria, examined their eyes to review the comorbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were reexamined 6 weeks postoperatively. We divided the cases of traumatic cataract into two groups, the "open globe" (Group 1) and "closed globe" (Group 2) groups, according to the ocular trauma based on the Birmingham Eye Trauma Terminology System (BETTS) and compared the determinants of visual acuity. RESULTS Our cohort of 555 eyes with traumatic cataracts included 394 eyes in Group 1 and 161 in Group 2. Six weeks postoperatively, the visual acuity in the operated eye was >20/60 in 193 (48%) and 49 (29%) eyes in Groups 1 and 2, respectively (P = 0.002, ANOVA). At follow-up, >20/60 vision was significantly higher in Group 1 than in Group 2 (OR = 1.61; 95% CI, 0.85-3.02). Overall 242 (43.5%) eyes gained a final visual acuity of >20/60. CONCLUSIONS Open globe injury has a favorable prognosis for satisfactory (>20/60) visual recovery after the management of traumatic cataracts.
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Affiliation(s)
- Mehul Shah
- Drashti Netralaya, Dahod, Gujarat, India.
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Comparative study of final visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract. Graefes Arch Clin Exp Ophthalmol 2011; 249:1775-81. [PMID: 21735239 DOI: 10.1007/s00417-011-1732-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 05/17/2011] [Accepted: 05/17/2011] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The objective of this work is to compare final visual outcomes in cases of surgically treated traumatic cataract between open-globe and closed-globe groups, as classified by the Birmingham Eye Trauma Terminology system. DESIGN Observational cohort study. SETTING Tertiary eye-care center at the trijunction of Gujarat, Madhya Pradesh, and Rajasthan states in central western India. METHODS We enrolled patients meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined 6 weeks postoperatively. We classified the cases of traumatic cataract as either open-globe (group 1) or closed-globe (group 2), according to the Birmingham Eye Trauma Terminology (BETT) system, and compared visual acuity. OUTCOME MEASURES Visual Acuity. RESULTS Our cohort of 687 eyes with traumatic cataracts included 496 eyes in group 1 and 191 in group 2. Six weeks postoperatively, the visual acuity was >20/60 in 298 (58%) and 75 (39.1%) operated eyes in groups 1 and 2, respectively (p < 0.001, ANOVA). At follow-up, >20/60 vision was significantly higher in group 1 than in group 2 (OR = 1.61; 95% CI, 0.85-3.02). Overall, 373 eyes (54.3%) regained final visual acuity >20/60. CONCLUSIONS Open-globe injury has a more favorable prognosis for satisfactory (>20/60) visual recovery after management of traumatic cataracts.
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Abstract
PURPOSE To review the changes in the surgical techniques used for cataract removal in the setting of trauma and their postoperative outcome. RECENT FINDINGS Primary cataract removal with intraocular lens (IOL) implantation is the commonly followed procedure for penetrating injuries with cataract. IOL implantation has evolved through various techniques namely 'in the bag', 'in the sulcus', epilenticular implantation, anterior chamber IOL, scleral fixated IOL and recently glued IOL. SUMMARY Certain lacerating injuries of the anterior segment are particularly amenable to cataract extraction and IOL implantation at the time of primary laceration repair. This approach obviates additional operative and anesthetic risks, while affording timelier visual rehabilitation. Secondary lens removal may also be indicated in cases of severe corneal injury and marked edema, which may interfere with intraocular visualization.
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Scholl HPN, Fleckenstein M, Krohne TU, Holz FG. Klassifikation biomedizinischer Forschungsberichte als Grundlage evidenzbasierter Medizin in der Augenheilkunde. Ophthalmologe 2005; 102:1152-61. [PMID: 16283184 DOI: 10.1007/s00347-005-1293-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Evidence-based medicine requires careful appraisal of published data derived from experimental and clinical studies. Based on classification of biomedical research reports, evidence levels can be determined and recommendations for therapeutic decisions can be made. METHODS A classification system for clinical studies was developed. It was evaluated in classifying the reports published in Der Ophthalmologe during 2003-2004 (study design: descriptive cross-sectional study, case series). RESULTS In the 2-year interval, 70 longitudinal and 95 cross-sectional studies were published. The vast majority of the longitudinal studies were interventional cohort studies. Not considering case reports, 73% of the original articles were longitudinal prospective studies, 1% were retrospective (case-control) studies, and 26% were cross-sectional studies. CONCLUSIONS The study design of all published articles could be classified using the classification system. This classification system proves to be applicable in the context of clinical studies in ophthalmology and may be helpful in the process of critical appraisal of the literature and synthesis of clinical evidence and an evidence-based recommendation.
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