Functional results after traumatic cataracts in 22 children aged under 7 years with posterior chamber lens implantation - a retrospective study

Background: Surgical correction of aphakia following traumatic cataract in children is discussed controversely in literature. This study shows the fun ctional results after cataract surgery with posterior chamber intraocular l ens implantation in children under 7 years of age. Patients and methods: This retrospective study analyzes the visual function of 22 children, who were operated after traumatic cataract between 1987 an d 1997 at the department of ophthalmology, university of Erlangen-Nurnberg with PCL-implantation. Mean age at injury was 3 years 10 months +/- 1 year 8 months (range 15 to 76 months); the interval between injury and cataract surgery: 2.7 +/- 4.7 months (range 0 to 17 months). The follow-up time was 5 years and 3 months +/- 3 years and 3 months (range 4 to 119 months). The axial length (AL) was measured by A-scan ultrasonography in 95% of the pati ents, and in 32% consecutive measurements of axial lengths were performed. Results: The mean result of visual acuity in the children with PCL implanta tion was for far distance 0.47 +/- 0.46 (range 0.001 to 1.25), median 0.35 and for near distance 0.37 +/- 0.4 (range 0.001 to 1.4), median 0.225. Read ing ability (crowded optotype acuity greater than or equal to 0.3) was achi eved in 9 of 22 injured eyes (41%). Binocularity was preserved in 59%, ster eo acuity in 55% of the children. Higher values of anisomyopia from - 2.25 to - 10.25 were found in 50% of the children. A tendency of eye length enla rgement of the operated in comparison with the non operated eye could not b e proved in our series. Conclusion: On the basis of PCL implantation a high frequency of eyes with reading ability (crowded optotype acuity greater than or equal to0.3) and o f stereo acuity can be achieved. Risk factors for very low visual acuity ar e: early age of injury with fast development of strabismus and slow develop ment of cataract in this early age resulting in late cataract operation.