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ORIGINAL ARTICLE
Year : 2012  |  Volume : 60  |  Issue : 5  |  Page : 481-486

Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India


1 Lions NAB Eye Hospital, Miraj, Sangli; Dr. Gogate's Eye Clinic, Pune, India
2 Lions NAB Eye Hospital, Miraj, Sangli, India
3 Lions NAB Eye Hospital, Miraj, Sangli; Dr. Kulkarni Eye Hospital, Miraj, Sangli, Maharashtra, India

Correspondence Address:
Parikshit Gogate
Lions NAB Eye Hospital, P-31, M.I.D.C., Miraj, District Sangli, Maharashtra
India
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Source of Support: ORBIS International, New York through the USAIDís AED Operational research project under the A2Z child micronutrient program, Conflict of Interest: None


DOI: 10.4103/0301-4738.100557

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Purpose : To describe preoperative factors, long-term (>3 years) postoperative outcome and cost of traumatic cataracts in children in predominantly rural districts of western India. Subjects : Eighty-two traumatic cataracts in 81 children in a pediatric ophthalmology department of a tertiary eye-care center. Materials and Methods : Traumatic cataracts operated in 2004-2008 were reexamined prospectively in 2010-2011 using standardized technique. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Statistical Analysis : Data analysis done by using SPSS (Statistical package for social sciences) version 17.0 We have used Chi-square test, Fisher's exact test, paired t-test to find the association between the final vision and various parameters at 5% level of significance; binary logistic regression was performed for visual outcome ≥6/18 and ≥6/60. Results : The children were examined in a 3-7 year follow-up (4.35 ± 1.54). Average age at time of surgery was 10.4 ± 4.43 years (1.03 to 18). Fifty (61.7%) were boys. Forty (48.8%) were blunt and 32 (39%) were sharp trauma. The most common cause was wooden stick 23 (28.0%) and sharp thorn 14 (17.1%). Delay between trauma and presentation to hospital ranged from same day to 12 years after the injury with median of 4 days. The mean preoperative visual acuity by decimal notation was 0.059 ± 0.073 and mean postoperative visual acuity was 0.483 ± 0.417 (P < 0.001). Thirty-eight (46.3%) had best corrected visual acuity (BCVA) ≥6/18 and 51 (62.2%) had BCVA ≥ 6/60. In univariable analysis, visual outcome (≥6/18) depended on type of surgery (P = 0.002), gender (P = 0.028), and type of injury (P = 0.07)-sharp trauma and open globe injury had poorer outcomes; but not on age of child, preoperative vision, and type of surgeon. On multivariable binary logistic regression, only gender was significant variable. Of the 82 eyes, 18 (22%) needed more than one surgery. The parents spent an average of Rs. 2250 ($45) for the surgery and 55 (66.4%) were from lower socio-economic class. Conclusion : The postoperative visual outcomes varied and less than half achieved ≥ 6/18.


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