Intraocular lens implantation for traumatic cataract in children in East Africa

Purpose: To review the visual outcomes and complications after intraocular lens (IOL) implantation in children with traumatic cataract in sub-Saharan Africa, where contact lenses for unilateral aphakia are impractical in most patients, Setting: PCEA Kikuyu Eye Unit, Nairobi, Kenya, East Africa. Methods: All children younger than 16 years having IOL implantation for tra umatic cataract between February 1993 and December 1998 (215 eyes) were ret rospectively reviewed. Complications and visual outcomes were evaluated. Results: The study group comprised 147 boys and 68 girls. The median interv al between injury and cataract surgery was 8 weeks. The most common causes of injury were stick (36.3%) and thorn (10.7%). Extracapsular cataract extr action with IOL implantation was performed in all patients. The most freque nt early complication was fibrinous uveltis in 110 eyes (51.2%), One hundre d sixty-seven eyes (77.7%) had 1 month or more followup, Of those, 108 eyes (64.7%) had a best corrected visual acuity of 20/60 or better. Twenty-one eyes (12.6%) had a visual acuity of worse than 20/200, with the most common causes being amblyopia (9/21) and retinal detachment (5/21). Amblyopia was found in 42 of 108 (38.9%) children aged 8 years or less at the time of in jury, Eyes with the IOL in the capsular bag were significantly less likely to require subsequent capsulotomy (P < .01) during the 2-year follow-up. Conclusion: The results indicate that posterior chamber IOLs can be safely implanted by experienced surgeons in most children older than 2 years with traumatic cataract and should be the standard of care throughout the world. (C) 2007 ASCPS and ESCRS.