Practice Patterns in the Surgical Management of Pediatric Traumatic Cataracts.

PURPOSE To facilitate the development of standardized guidelines for the surgical management of patients with pediatric traumatic cataracts by assessing current ophthalmologists' practice patterns. METHODS This was a cross-sectional, observational, and retrospective study. A 24-question electronic survey of current practices pertaining to the surgical management of pediatric traumatic cataracts was sent to pediatric ophthalmologists worldwide. Preferences for pre-operative evaluation, surgical timing and techniques, and postoperative management were analyzed. RESULTS Of the 56 respondents, 62.5% practiced in academic settings. Of the 49 respondents (87.5%) who performed pediatric ruptured globe repair, 41.7% would perform simultaneous cataract extraction if anterior capsular violation existed, whereas 4.1% would do so without capsular violation (P < .001). Most respondents (50.9%) would remove visually significant cataracts within 4 weeks in patients within the amblyogenic age range (P = .02), whereas 63.6% would wait longer outside the amblyogenic range. Preferences for intraocular lens selection, primary posterior capsulotomy, and timing of amblyopia therapy differed. CONCLUSIONS Individual management practices regarding pediatric traumatic cataracts vary depending on associated globe injuries and patient age. Trends exist in surgical planning, intraoperative techniques, and visual rehabilitation methods, but no single approach has achieved complete unanimity. Therefore, further investigation into optimal timing and the extent of surgical intervention, refractive correction, and postoperative care is necessary prior to developing evidence-based guidelines for enhancing visual outcomes in this population. [J Pediatr Ophthalmol Strabismus. 2020;57(3):190-198.].

[1]  Jennifer L. Jung,et al.  Frequency of pediatric traumatic cataract and simultaneous retinal detachment. , 2018, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[2]  Alok Sen,et al.  Primary versus secondary intraocular lens implantation in traumatic cataract after open-globe injury in pediatric patients. , 2018, Journal of cataract and refractive surgery.

[3]  M. Zimmermann-Paiz,et al.  Traumatic cataract surgery in pediatric patients. Experience in a site. , 2018, Archivos argentinos de pediatria.

[4]  M. Shah,et al.  Comparative study of visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract in children , 2018, European journal of ophthalmology.

[5]  Xiangjia Zhu,et al.  Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study , 2018, Scientific Reports.

[6]  Monika Vieversytė,et al.  A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma , 2018, BMC Ophthalmology.

[7]  R. Agrawal,et al.  Pediatric ocular trauma score as a prognostic tool in the management of pediatric traumatic cataracts , 2017, Graefe's Archive for Clinical and Experimental Ophthalmology.

[8]  S. Read,et al.  Traumatic open globe injury in young pediatric patients: characterization of a novel prognostic score. , 2016, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[9]  Ahmed Fathalla,et al.  Effect of Intracameral Triamcinolone Acetonide on Postoperative Intraocular Inflammation in Pediatric Traumatic Cataract , 2016, European journal of ophthalmology.

[10]  J. Jonas,et al.  Prevalence and Associations of Anisometropia in Children. , 2016, Investigative ophthalmology & visual science.

[11]  T. Agarwal,et al.  Epidemiology and Intermediate-Term Outcomes of Open- and Closed-Globe Injuries in Traumatic Childhood Cataract , 2014, European journal of ophthalmology.

[12]  T. Wygnanski-Jaffe,et al.  Traumatic pediatric cataract in southern Ethiopia--results of 49 cases. , 2013, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[13]  Yusen Huang,et al.  Pediatric traumatic cataract and surgery outcomes in eastern China: a hospital-based study. , 2013, International journal of ophthalmology.

[14]  P. Gogate,et al.  Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India , 2012, Indian journal of ophthalmology.

[15]  M. Shah,et al.  Ocular Trauma Score as a predictor of final visual outcomes in traumatic cataract cases in pediatric patients , 2012, Journal of cataract and refractive surgery.

[16]  A. Şahin,et al.  Posterior chamber lens implantation with scleral fixation in children with traumatic cataract. , 2011, Journal of pediatric ophthalmology and strabismus.

[17]  H. Völker‐Dieben,et al.  Traumatic pediatric cataract: a decade of follow-up after Artisan aphakia intraocular lens implantation. , 2007, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[18]  Kamlesh,et al.  Management of paediatric traumatic cataract by epilenticular intraocular lens implantation: long-term visual results and postoperative complications , 2004, Eye.

[19]  R. O. Schultz,et al.  Pseudophakia for Traumatic Cataracts in Children , 1993 .

[20]  E. Maul,et al.  The management of lens damage in perforating corneal lacerations. , 1978, The British journal of ophthalmology.

[21]  J. Ram,et al.  Visual outcomes of pediatric traumatic cataracts , 2019, European journal of ophthalmology.

[22]  K. Mireskandari,et al.  Refractive and visual outcomes after surgery for pediatric traumatic cataract. , 2018, Journal of cataract and refractive surgery.

[23]  R. Cheema,et al.  Visual recovery in unilateral traumatic pediatric cataracts treated with posterior chamber intraocular lens and anterior vitrectomy in Pakistan , 2004, International Ophthalmology.