Govindraj, B (2013) Primary intraocular lens implantation in traumatic cataract:visual outcome. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Cataract is the commonest cause for blindness in India (62.60%). Traumatic cataract accounts for about 29% of pediatric cataracts. Ocular trauma is an important cause of visual loss, and cataract formation following trauma is an important cause for visual loss after ocular trauma. Traumatic cataract may be caused by blunt or penetrating ocular trauma, electric shocks, ionizing radiations like x-rays, non- ionizing radiations such as infrared and ultraviolet light. Children and young adults are more prone for trauma and have a higher incidence of traumatic cataract. In traumatic cataract lens needs to be removed and as the other eye remains normal in most of the cases, the problem of unilateral aphakia sets in. spectacle correction and contact lens help to certain extent only in developing binocular vision. The timing of surgery is important for visual rehabilitation especially in children as the risk of amblyopia is high due to media opacity. Several studies have revealed early cataract extraction with primary intraocular lens implantation in traumatic cataract results in good vision. This study was done at Govt. Rajaji Hospital, Madurai to assess the visual rehabilitation that can be achieved following cataract extraction and primary intraocular lens implantation in traumatic cataract caused by blunt and penetrating ocular injuries. This study is done with reference to age, etiology, associated ocular injuries, type of surgery, surgical complications, and final visual outcome after cataract surgery and primary intraocular lens implantation. AIMS AND OBJECTIVES: To assess the visual outcome of cataract extraction with primary intraocular lens implantation for traumatic cataract caused by blunt and penetrating ocular injuries. MATERIALS AND METHODS: The present study consists of 34 cases of traumatic cataract in age group of 5 to 50 years attending Government Rajaji Hospital, Madurai Medical College, Madurai. The study was done for a period of nine months from March 2012 to November 2012. Out of 34 cases, 24 were male and 10 were female. Out of 34 cases, 29 cases underwent small incision cataract surgery with posterior chamber intraocular lens implantation, 5 cases underwent small incision cataract surgery with anterior chamber intraocular lens implantation because of posterior capsular rupture. These 34 cases were taken proper and detail history regarding cause of trauma, duration, associated ocular injury; intraoperative and postoperative complications were noted. The visual prognosis after the surgery was noted. SUMMARY: This is a prospective study carried out over a period of nine months at Government Rajaji Hospital, Madurai Medical College, Madurai. The present study of 34 cases of traumatic cataract includes patients from age of 5-60 years. This study is based on age wise analysis, etiological distribution of traumatic cataract, type of cataract, associated ocular injuries, surgical complication and final visual outcome after cataract extraction and primary intraocular lens implantation. Traumatic cataract can occur following ocular trauma, along with damage to other ocular structures. Both penetrating and blunt trauma can cause traumatic cataract. Young individuals between 11-30 years had increased incidence of traumatic cataract, this is because of greater involvement of outdoor activity. Most of the injuries resulted from wooden stick. In this study there was male preponderance because men are exposed to ocular trauma because of their occupation and they formed wage earning group in rural areas. Penetrating injury was common mode of injury when compared to blunt trauma. The associated ocular damage were injury to cornea in the form of scar or opacity, injury to the iris in the form of traumatic mydriasis, anterior synechiae, posterior synechiae and subluxation of lens. The cases were managed by small incision cataract surgery with posterior or anterior chamber intraocular lens implantation. Twenty nine cases underwent SICS with posterior chamber IOL implantation. Five cases underwent SICS with anterior chamber IOL implantation. Postoperative complications such as striate keratopathy, shallow anterior chamber, uveitis, hyphema and PCO were observed. These postoperative complications were managed with appropriate topical antibiotic and steroid eye drops. Final visual outcome showed good results i.e. 22 cases (64.71%) had visual acuity between 6/6 to 6/12, 9 cases (26.47%) had visual acuity between 6/18 to 6/60 and 3 cases (8.82%) had visual acuity less than 6/60. It is observed that traumatic cataract extraction and primary IOL implantation will give good visual outcome thereby saving the eyes from being amblyopic and divergent.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Primary intraocular lens implantation; traumatic cataract; visual outcome |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 21 Sep 2017 10:16 |
| Last Modified: | 21 Sep 2017 16:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3247 |
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