TY - JOUR
T1 - Visual Outcomes and Complications after Lensectomy for Traumatic Cataract in Children
AU - Bothun, Erick D.
AU - Repka, Michael X.
AU - Dean, Trevano W.
AU - Gray, Michael E.
AU - Lenhart, Phoebe D.
AU - Li, Zhuokai
AU - Morrison, David G.
AU - Wallace, David K.
AU - Kraker, Raymond T.
AU - Cotter, Susan A.
AU - Holmes, Jonathan M.
N1 - Funding Information:
reported consulting for Alcon since August 2020 for purposes of explaining the Pediatric Eye Disease Investigator Group (PEDIG) Cataract Registry data to the company for their possible use in a US Food and Drug Administration labeling application. Mr Dean reported receiving grants from the National Eye Institute of the National Institutes of Health (NEI/NIH) during the conduct of the study. Dr Wallace reported receiving grants from the NEI/NIH during the conduct of the study. Mr Kraker reported receiving grants from the NEI/NIH for the Jaeb Center for Health Research as a coordinating center for PEDIG research during the conduct of the study. Dr Cotter reported receiving grants from the NEI/NIH during the conduct of the study. Dr Holmes reported receiving grants from the NIH during the conduct of the study and outside the submitted work. No other disclosures were reported.
Funding Information:
Funding/Support: This study was supported by
Publisher Copyright:
© 2021 American Medical Association. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Importance: The Pediatric Eye Disease Investigator Group Cataract Registry provides a multicenter assessment of visual outcomes and complications after lensectomy for traumatic pediatric cataract. Objective: To report visual acuity (VA) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months after lensectomy for traumatic cataract among children younger than 13 years at the time of surgery. Design, Setting, and Participants: From June 18, 2012, to July 8, 2015, 1266 eyes of 994 children from 33 pediatric eye care practices seen within 45 days after lensectomy were enrolled in a multicenter, prospective observational registry. Of these, 74 eyes of 72 participants undergoing lensectomy for traumatic cataract were included in a cohort study. Follow-up was completed by November 2, 2015, and data were analyzed from March 20, 2018, to July 7, 2020. Exposures: Lensectomy after ocular trauma. Main Outcomes and Measures: Best-corrected VA from 9 to 15 months after lensectomy for traumatic cataract (for those 3 years or older) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months. Results: Of 994 participants in the registry, 84 (8%) had traumatic cataract. The median age at lensectomy for 72 participants examined within 15 months after surgery was 7.3 (range, 0.1-12.6) years; 46 (64%) were boys. An intraocular lens was placed in 57 of 74 eyes (77%). In children 3 years or older at outcome, the median best-corrected VA was 20/250 (range, 20/20 to worse than 20/800) in 6 eyes with aphakia and 20/63 (range, 20/20 to 20/200) in 26 eyes with pseudophakia. Postoperative visual axis opacification was reported in 18 of 27 eyes with pseudophakia without primary posterior capsulotomy (15-month cumulative proportion, 77%; 95% CI, 58%-92%). The cumulative proportion with strabismus was 43% (95% CI, 31%-58%) in 64 participants with ocular alignment data; exotropia was present in 14 of 23 participants (61%). The cumulative proportion with glaucoma was 6% (95% CI, 2%-16%). Conclusions and Relevance: Trauma was not a common cause of pediatric cataract requiring surgery. For children with traumatic cataract, substantial ocular morbidity including permanent vision loss was found, and long-term eye and vision monitoring are needed for glaucoma, strabismus, and capsular opacification..
AB - Importance: The Pediatric Eye Disease Investigator Group Cataract Registry provides a multicenter assessment of visual outcomes and complications after lensectomy for traumatic pediatric cataract. Objective: To report visual acuity (VA) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months after lensectomy for traumatic cataract among children younger than 13 years at the time of surgery. Design, Setting, and Participants: From June 18, 2012, to July 8, 2015, 1266 eyes of 994 children from 33 pediatric eye care practices seen within 45 days after lensectomy were enrolled in a multicenter, prospective observational registry. Of these, 74 eyes of 72 participants undergoing lensectomy for traumatic cataract were included in a cohort study. Follow-up was completed by November 2, 2015, and data were analyzed from March 20, 2018, to July 7, 2020. Exposures: Lensectomy after ocular trauma. Main Outcomes and Measures: Best-corrected VA from 9 to 15 months after lensectomy for traumatic cataract (for those 3 years or older) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months. Results: Of 994 participants in the registry, 84 (8%) had traumatic cataract. The median age at lensectomy for 72 participants examined within 15 months after surgery was 7.3 (range, 0.1-12.6) years; 46 (64%) were boys. An intraocular lens was placed in 57 of 74 eyes (77%). In children 3 years or older at outcome, the median best-corrected VA was 20/250 (range, 20/20 to worse than 20/800) in 6 eyes with aphakia and 20/63 (range, 20/20 to 20/200) in 26 eyes with pseudophakia. Postoperative visual axis opacification was reported in 18 of 27 eyes with pseudophakia without primary posterior capsulotomy (15-month cumulative proportion, 77%; 95% CI, 58%-92%). The cumulative proportion with strabismus was 43% (95% CI, 31%-58%) in 64 participants with ocular alignment data; exotropia was present in 14 of 23 participants (61%). The cumulative proportion with glaucoma was 6% (95% CI, 2%-16%). Conclusions and Relevance: Trauma was not a common cause of pediatric cataract requiring surgery. For children with traumatic cataract, substantial ocular morbidity including permanent vision loss was found, and long-term eye and vision monitoring are needed for glaucoma, strabismus, and capsular opacification..
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U2 - 10.1001/jamaophthalmol.2021.0980
DO - 10.1001/jamaophthalmol.2021.0980
M3 - Article
C2 - 33956055
AN - SCOPUS:85105942884
SN - 2168-6165
VL - 139
SP - 647
EP - 653
JO - JAMA Ophthalmology
JF - JAMA Ophthalmology
IS - 6
ER -