Safety of primary intraocular lens insertion in unilateral childhood traumatic cataract

This study analyzes the results of cataract surgery with primary intraocular lens implantation in unilateral childhood traumatic cataract following penetrating trauma and its long term follow up. It is a hospital based study of 114 children (age 3-10 years) with unilateral traumatic cataract who underwent extracapsular cataract extraction/ lens aspiration with implantation of posterior chamber intraocular lens (IOL). Primary posterior capsulotomy (PPC) was performed in 57 eyes and the rest 57 were without PPC (NPPC). The patients were followed up at regular intervals for a period of 3 years. Postoperative inflammation and pupillary capture were two frequent complications seen during postoperative period. Development of posterior capsular opacification (PCO) was 1/57, 4/57 at 8^th week and 7/30 and 14/39 at 6 months, in PPC and NPPC group, respectively. Best corrected visual acuity (BCVA) ≥ 6/18 was achieved in 50% of eyes at 8^th week post operatively and the same at 3 years with/without membranectomy/capsulotomy was evident in 73.3% of eyes. Meticulous case selection with insersion of "in the bag IOL" and subjecting the traumatized cataractous eyes to primary posterior capsulotomy are factors responsible for optimal outcome in unilateral traumatic cataract in children.