Visual outcome following cataract surgery in patients with traumatic cataract in a tertiary hospital, South India

To analyze the intraoperative complications and postoperative outcome during cataract extraction in traumatic cataract.

A retrospective analysis of all the traumatic cataracts presenting at M.S. Ramaiah Medical College Hospital during the period between January 2011 and December 2015 was done. A total of 41 traumatic cataract cases were seen during the 5-year period. Age, Sex, traumatic sequelae, surgical strategies, intraoperative complications and post-operative outcome were reviewed in all eyes.

Records of forty-one patients with traumatic cataract were analyzed. Males accounted for 90.24%, while females, for 9.76%. Thirty-five patients (85.36%) underwent surgery for traumatic cataract. A history of blunt trauma was elicited in 23(56.09%) and 18(43.91%) had a penetrating trauma. It was noted that the presence of corneal changes or iris abnormalities, did not affect the visual outcome. Pupillary changes influenced the visual outcome, with100% of the patients with a relative afferent pupillary defect and a fixed dilated pupil having a vision worse than CF3m. (p <0.005). Among the intraoperative complications, vitreous loss had a bearing on the post-operative vision. Twelve percent of the patients had a vitreous loss, all of whom had a vision of 6/60 or worse. (p=0.028). The presence of postoperative complications also affected the visual outcome-78.6% of whom, had a vision 6/24 or worse. (p=0.05).

Traumatic cataracts pose a challenge to ophthalmologists, as they have an increased incidence of associated ocular abnormalities and intraoperative complications. Hence, pre-operative counselling of the patient, astute surgical planning, careful surgical management and an intense post-operative follow up regime are imperative in the management of traumatic cataracts, to attain a reasonable visual outcome.