TRAUMATIC CATARACT: ANATOMICAL AND FUNCTIONAL OUTCOMES

This study describes epidemiological and clinical profiles of adult post-traumatic cataracts and assesses postoperative outcomes.

Department of ophtalmology A , institute of ophtalmology hedi rais Tunis

A retrospective study of 62 patients over 16 years old with post-traumatic cataract at IHROT Service A (2010-2018). Key parameters included demographics, trauma type, injuring agent, time to consultation, initial visual acuity, eye exam findings, surgical type, outcomes, and complications. Average follow-up was 2 months.

Patients averaged 40 years, with 77.1% male. Domestic accidents caused 53.2% of cases, and assaults 20.9%. Trauma was penetrating in 72.6% and blunt in 27.4%. Metallic agents caused 37.1% of injuries, plant-based 17.7%. Half of the patients (55.4%) sought emergency care within 24-48 hours, with initial visual acuity reduced to light perception in 77.5%. Cataracts were total in 64.5%, including 27.5% with anterior capsule rupture and 15% with posterior capsule rupture. Dislocation occurred in 14% of cases. Corneal wounds were present in 62.9%, hyphema in 14.5%, and posterior segment injuries in 6.5%.
Phacoemulsification was performed in 78.3%; of these, 59.7% received posterior chamber implants, 3.2% artisan lenses, and 1.6% anterior chamber implants. Eleven patients remained aphakic. Anterior vitrectomy was performed in 24.2%, mainly due to intraoperative capsular rupture. Final visual acuity was less than 1/10 in 67.7%. Postoperative complications included endophthalmitis (2 cases), ocular hypertension (11 cases), phacogenic uveitis (1 case), and two cases progressed to phthisis bulbi.

Visual prognosis in traumatic cataract is closely tied to associated injuries. Preventing eye trauma, especially in occupational settings, is crucial.