Características del trauma ocular en pacientes diagnosticados con catarata traumática

Objetivo: Determinar las características del trauma ocular en pacientes diagnosticados con catarata traumática. Métodos: Se realizó un estudio observacional descriptivo de corte transversal con 335 pacientes diagnosticados con catarata traumática. Las variables incluyeron edad, sexo, ojo afectado, lugar de ocurrencia del trauma, uso de protección en el entorno laboral, tipo de trauma ocular, daños asociados, morfología de la catarata y zona de lesión. Resultados: La edad promedio de los pacientes fue de 52,2 ± 14,8 años. Se observó un predominio del sexo masculino (75,5 %) y la mayoría de los casos presentaron un trauma ocular cerrado (70,4 %). El ojo derecho fue más afectado (64,8 %). En cuanto al lugar de ocurrencia del traumatismo ocular, el 49,9 % de los casos se produjo en el contexto laboral, y la mayoría de los pacientes que experimentaron un trauma ocular abierto no utilizaban protección ocular. Las lesiones asociadas más comunes fueron el aumento de la presión intraocular, la ruptura de la cápsula y las sinequias, la diálisis del iris. En cuanto a la morfología de las cataratas, se observó que predominaba la opacidad total. Conclusiones: Este estudio subraya la importancia de estrategias preventivas, especialmente en entornos laborales propensos a lesiones oculares. La falta de protección ocular en casos de trauma ocular abierto enfatiza la necesidad de concienciar a la población sobre la importancia de medidas de seguridad adecuadas. Estos hallazgos pueden guiar intervenciones clínicas y políticas de salud pública para reducir la incidencia y las secuelas de la catarata traumática.

Objective: Determine the characteristics of ocular trauma in patients diagnosed with traumatic cataract. Methods: A cross-sectional descriptive observational study was carried out with 335 patients diagnosed with traumatic cataract. The variables included age, sex, affected eye, location of trauma occurrence, use of protection in the work environment, type of ocular trauma, associated damage, cataract morphology and area of injury. Results: The average age of the patients was 52.2 ± 14.8 years. A predominance of males was observed (75.5%) and the majority of cases presented blunt ocular trauma (70.4%). The right eye was more affected (64.8%). Regarding the place of occurrence of ocular trauma, 49.9% of cases occurred in the work context, and the majority of patients who experienced open ocular trauma did not use eye protection. The most common associated injuries were increased intraocular pressure, capsule rupture and synechiae, iris dialysis. Regarding the morphology of the cataracts, it was observed that total opacity predominated. Conclusions: This study highlights the importance of preventive strategies, especially in work environments prone to eye injuries. The lack of eye protection in cases of open eye trauma emphasizes the need to raise public awareness about the importance of adequate safety measures. These findings may guide clinical interventions and public health policies to reduce the incidence and sequelae of traumatic cataract.

Management of pediatric subluxated cataract and different methods to face the challenges

Background: Traumatic cataracts present in multiple and different forms. Based on the nature of injury, it necessitates a customized approach for individual case. Capsulorhexis and in the bag intraocular lens (IOL) placement are vital for long term centration of pediatric IOLs. Paediatric lenses having elastic capsule provide more challenges to perform optimum rhexis and the surgery becomes further complicated, when it is subluxated or fibrosed. Here is a pediatric case with such challenges managed using capsular tension ring (CTR) and capsular tension segment (CTS). Purpose: To demonstrate the making of optimum rhexis in a fibrosed capsule in subluxated lens and placing the IOL along with fixation of bag using CTR and CTS. Synopsis: A 13?year?old boy sustained an injury in the right eye from an air pistol, underwent lid tear repair in a local hospital, and presented to us one month post trauma with visual acuity of 6/60 in the right eye and 6/6 in the left eye. On examination, there was more than 180° temporal zonular dialysis with fibrosis of the anterior capsule. In this situation, creating an intact capsulorhexis was a challenge which was solved using micro?scissors and micro?vitreo?retinal forceps, in addition to routine instruments. After removing the lens material, CTS was placed initially in the bag to stabilize it while introducing CTR. The CTS was then fixated to the sclera. Foldable IOL was placed in the bag. Technique and tips to make intact rhexis and easy passage of suture are demonstrated. Highlights: This video shows tips and different methods adopted in each step of the surgery for successful placement of IOL in bag along with fixation of bag using CTR and CTS in a case of traumatic subluxated cataract with shrunken anterior lens capsule.

New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models

Purpose: Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. Methods: This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer’s exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. Results: We enrolled 124 eyes. Patients’ mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed? and open?globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. Conclusion: TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. All the examined scores can be helpful in estimating VA following treatment

Iridodialysis repair – A simplified approach

Background: Iris root is the thinnest and weakest portion of the iris stroma. It can detach easily due to blunt trauma or accidental engagement of the iris during intraocular surgery resulting in glare, photophobia and monocular diplopia. Multiple techniques described for iridodialysis repair such as hang back technique, stroke and dock technique and sewing machine technique are technically challenging. Purpose: To describe an simplified approach of iridodialysis repair using 9?0 prolene suture. Synopsis: We demonstrate the technique of iridodialysis repair using animation for better understanding. Scleral flap is made adjacent to the iridodialysis area and a paracentesis is made oppsite to the iridodialysis. One arm of the double armed straight needle with 9?0 prolene suture is passed through the paracentesis into the iris root and docked in the 26G needle which is passed underneath the scleral flap 1.5mm posterior to the limbus. Then the needle is pulled out underneath the scleral flap and the manoeuvre is repeated for the second arm as well. The sutures are secured with 5?6 knots under the scleral flap. Intra? operative surgical videos of two patients with traumatic cataract and iridodialysis following blunt trauma are shown. After stabilizing the detached iris using iris hooks, phacoemlsification is done with implantation of foldable acrylic IOL, followed by iridodialysis repair as described above. Both the patients were relieved of their pre?operative symtoms and had good visual recovery. Highlights: We describe a simplified approach of iridodialysis repair that can significantly reduce the patient’s troublesome symptoms such as glare and monocular double vision.

Management of pediatric subluxated cataract and different methods to face the challenges

Background: Traumatic cataracts present in multiple and different forms. Based on the nature of injury, it necessitates a customized approach for individual case. Capsulorhexis and in the bag intraocular lens (IOL) placement are vital for long term centration of pediatric IOLs. Paediatric lenses having elastic capsule provide more challenges to perform optimum rhexis and the surgery becomes further complicated, when it is subluxated or fibrosed. Here is a pediatric case with such challenges managed using capsular tension ring (CTR) and capsular tension segment (CTS). Purpose: To demonstrate the making of optimum rhexis in a fibrosed capsule in subluxated lens and placing the IOL along with fixation of bag using CTR and CTS. Synopsis: A 13?year?old boy sustained an injury in the right eye from an air pistol, underwent lid tear repair in a local hospital, and presented to us one month post trauma with visual acuity of 6/60 in the right eye and 6/6 in the left eye. On examination, there was more than 180° temporal zonular dialysis with fibrosis of the anterior capsule. In this situation, creating an intact capsulorhexis was a challenge which was solved using micro?scissors and micro?vitreo?retinal forceps, in addition to routine instruments. After removing the lens material, CTS was placed initially in the bag to stabilize it while introducing CTR. The CTS was then fixated to the sclera. Foldable IOL was placed in the bag. Technique and tips to make intact rhexis and easy passage of suture are demonstrated. Highlights: This video shows tips and different methods adopted in each step of the surgery for successful placement of IOL in bag along with fixation of bag using CTR and CTS in a case of traumatic subluxated cataract with shrunken anterior lens capsule.

Efectividad del Ocular Trauma Score en la predicción de los resultados visuales en pacientes con catarata traumática / Effectiveness of the Ocular Trauma Score to predict visual outcomes in traumatic cataract patients

Objetivo: Evaluar la efectividad del Ocular Trauma Score como factor pronóstico de la agudeza visual final en pacientes con diagnóstico de catarata traumática. Métodos: Se realizó un estudio descriptivo, longitudinal y de evaluación de un sistema pronóstico en una serie de 61 casos. Los pacientes fueron divididos en dos grupos de acuerdo con el mecanismo del trauma. Se estudió la relación entre la agudeza visual a los tres meses después de la cirugía de catarata y las variables demográficas y clínicas. El resultado visual se predijo mediante el Ocular Trauma Score y se comparó con el obtenido. Resultados: La mediana de la edad de los pacientes estudiados fue de 52,8 (RI: 44,0-63,0) años. Los pacientes con antecedentes de trauma abierto tendieron a ser más jóvenes: 50,5 (RI: 43,0-54,0) años de edad vs. 57,0 (RI: 45,5-65,5) años. Predominaron los pacientes del sexo masculino (85,2 por ciento) y de baja escolaridad (55,7 por ciento). Se observó mejoría de la agudeza visual mejor corregida después de la cirugía, en particular en los pacientes con trauma cerrado. El Ocular Trauma Score pronosticó adecuadamente para agudeza visual de 20/40 o más. Conclusiones: Se logran buenos resultados con el uso del Ocular Trauma Score como factor pronóstico de la agudeza visual en pacientes con diagnóstico de catarata traumática(AU)

Objective: Evaluate the effectiveness of the Ocular Trauma Score as a prognostic factor for final visual acuity in patients diagnosed with traumatic cataract. Methods: A descriptive longitudinal evaluative study was conducted of a prognostic system in a series of 61 cases. The patients were divided into two groups according to the trauma mechanism. An analysis was performed of the relationship between visual acuity three months after cataract surgery and clinical and demographic variables. Visual outcome was predicted with the Ocular Trauma Score and then compared with the result obtained. Results: Mean age of the patients studied was 52.8 (IR 44.0-63.0) years. Patients with a history of open trauma tended to be younger: 50.5 (IR: 43.0-54.0) years vs. 57.0 (IR: 45.5-65.5) years. A predominance was found of male sex (85.2 percent) and a low educational level (55.7percent. Best corrected visual acuity was found to improve after surgery, particularly in patients with closed trauma. The Ocular Trauma Score predicted appropriately for visual acuity values of 20/40 or higher. Conclusions: Good results are obtained with the use of the Ocular Trauma Score as a prognostic factor for visual acuity in patients diagnosed with traumatic cataract(AU)

Effect of corneal suture tensions on the accuracy of intraocular lens power calculation in traumatic cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of corneal suture tension on the accuracy of intraocular lens power calculation in traumatic cataract.<p>METHODS: In this prospective study, 57 patients who were waiting for secondary intraocular lens implantation surgery with sutured corneal penetrating injury and extracted traumatic cataract in our hospital from March 2017 to March 2019, were divided into observation group and control group. Corneal sutures were removed one week before operation in the observation group, while corneal sutures were removed during the operation in the control group. The corneal curvature, corneal astigmatism, anterior chamber depth, axial length and theoretical intraocular lens power in the observation group were compared before and after suture removal; the postoperative uncorrected visual acuity and corneal astigmatism were compared between the observation group and the control group.<p>RESULTS: There were significant changes in corneal curvature(43.15±1.32D <i>vs</i> 45.05±1.20D), corneal astigmatism(-5.23±2.52D <i>vs</i> -2.04±1.44D)and theoretical intraocular lens power(22.24±2.36D <i>vs</i> 20.40±1.46D)before and after suture removal(<i>P</i><0.05), while there were no difference in anterior chamber depth and axis length in the observation group(<i>P</i>Symbol～@@0.05). The uncorrected visual acuity was better, and the corneal astigmatism was lower 1d, 1wk, 1mo and 3mo post-operative in the observation group than that in the control group(<i>P</i><0.05).<p>CONCLUSION: Corneal suture tension has significant effect on corneal astigmatism, theoretical intraocular lens power calculation and postoperative refraction in traumatic cataract patients.

Anterior segment reconstruction and secondary posterior chamber intraocular lens implantation supported by fibromembrane / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the methods and effects of secondary intraocular lens implantation based on proliferative membrane in anterior segment reconstruction.<p>METHODS: Totally 156 eyes with penetrating injury had varying degrees of anterior segment disorders which had secondary intraocular lens implantation based on proliferative membrane to anterior segment reconstruction. Including partial penetrating keratoplasty, front-adhesion release, iris root suture, post-adhesion release, pupillary plasty, hole making in pupil area proliferative membrane and secondary intraocular lens implantation based on proliferative membrane. All patients were followed up 3-18mo.<p>RESULTS: The surgeries were successful in all patients. The corrected visual acuity of 123 eyes(78.8%)were ≥0.5, 17 eyes(10.9%)were ≥0.8 and 33 eyes(21.2%)were ≤0.4. Postoperative intraocular lens position was 133 eyes(85.3%), intraocular lens slightly off the center of 23 eyes(14.7%). Anterior chamber hemorrhage occurred in 8 eyes, 6 of them were recovered by conservative treatment and the blood membrane in another 2 eyes were sucked out through primary incision, and 5 cases of corneal plaque dense in the center of the cornea are partially penetrating keratoplasty. After 2mo, a rejection reaction occurs, which is cured by conservative treatment. All patients had slight postoperative inflammation and without severe long-term complications.<p>CONCLUSION: Reconstruction of the anterior segment of the eye, proliferative membrane can support the intraocular lens at the pre-implantation of the intraocular lens, without the need for suture fixation, thus avoiding various complications due to sutures.

The treatment effect of intraocular lens ciliary sulcus implantation combined with posterior capsular incarceration of intraocular lens on children with traumatic cataract / 中华实验眼科杂志

Objective To compare the treatment effect of intraocular lens ciliary sulcus implantation combined with posterior capsular incarceration of intraocular lens and simple intraocular lens ciliary sulcus implantation.Methods We retrospectively analyzed 60 eyes of 60 children with traumatic cataract from June 2012 to June 2015 in the Second People's Hospital of Yunnan Province,including 44 males and 16 females and the average age ranged from 1 to 14 years.The patients were divided into two groups according to the situation of posterior capsular,30 eyes of 30 children for each group.The patients in combined surgery group were performed intraocular lens ciliary sulcus implantation combined with posterior capsular incarceration of intraocular lens,and the patients in simple surgery group were performed simple intraocular lens ciliary sulcus implantation.The follow-up time ranged from 1 month to 6 months.The best corrected visual acuity(BCVA),grade of optic axis turbid,dislocation of intraocular lens,postoperative complications and surgical duration were compared between the two groups.Results The BCVA after surgery was significantly different from that before surgery in both groups (combined surgery group:x2 =7.548,P＜ 0.05;simple surgery group:x2 =5.579,P＜0.05).The postoperative turbidity of central axis area and BCVA were not significantly different between the 2 groups (x2 =0.362,P＞0.05).The dislocation degree of intraocular lens and proportion of postoperative complications were lower in the combined surgery group than those in the simple surgery group (x2 =9.858,P＜0.05;x2 =7.200,P＜0.05).The duration of surgery was not significantly different between the 2 groups (x2 =0.658,P ＞ 0.05).Conclusions Posterior capsular incarceration of intraocular lens has fewer complications,lower dislocation degree of intraocular lens and more effective for children with traumatic cataract than intraocular lens ciliary sulcus implantation.

Effects of different phases IOL implantation on the postoperative visual recovery and complications in patients with traumatic cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the visual recovery and complications in patients with traumatic cataract treated by intraocular lens Ⅰ phase implantation and Ⅱ phase implantation.?METHODS: Totally 86 patients with traumatic cataract (86 eyes) treated in our hospital from January 2014 to December 2016 were enrolled in the retrospective study, and they were divided into the control group ( treated by intraocular lens Ⅰ phase implantation, 46 eyes) and the observation group ( treated by intraocular lens Ⅱ phase implantation, 40 eyes). The general situation of surgery, the visual recovery at 6mo after operation and the incidence rate of complications in two groups were observed.?RESULTS: There were no significant differences in surgical time, intraoperative blood loss and hospitalization time between the two groups (P>0. 05). There was no significant difference in the excellent and good rate of visual acuity between the two groups before operation between the twogroups (P>0. 05). At 6mo after operation, the excellent and good rates of visual acuity in two groups obviously increased ( P<0. 05 ), while there was no significant difference in the excellent and good rates of visual acuity at 6mo after operation between the two groups ( P > 0. 05 ). There was no significant difference between the two groups in the incidence rates of posterior capsule rupture and vitreous body prolapse (P>0. 05). The incidence rates of corneal edema, iridocyclitis and posterior capsular opacification in the observation group after operation were significantly lower than those in control group (P<0. 05).?CONCLUSION:The effects of IOLⅠphase implantation and Ⅱ phase implantation are similar in patients with traumatic cataract, in terms of the general situation and improvement of visual recovery. However, the incidence of complications after Ⅱ phase implantation is relatively lower.

Clinical application of anterior chamber injection of triamcinolone acetonide during traumatic cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy and safety of triamcinolone acetonide(TA)injected in anterior chamber during traumatic cataract surgery.<p>METHODS: From January 2013 to May 2016, 31 cases(31 eyes)of traumatic cataract were involved in our study. To identify whether there was vitreous loss and confirm the location of vitreous body, all the cases were injected TA into the anterior chamber respectively in surgery. Totally 13 cases(13 eyes)with intact posterior lens capsules were performed the small incision non-phacoemulsification cataract surgery. The others, 18 cases(18 eyes)with posterior capsule rupture and vitreous loss were performed with the anterior vitrectomy combined with small incision non-phacoemulsification cataract surgery. The follow-up time was for 6-12mo. <p>RESULTS: Tirty-one cases were completed the operation successfully. All the cases with second-stage penetrating corneal trauma were implanted intraocular lens(IOL). The other cases with first-stage penetrating corneal trauma were not implanted IOL. Eighteen cases, which were confirmed with posterior capsule rupture and vitreous loss by injecting TA into the anterior chamber,were consistently improved the visualization of vitreous cortex and treated with anterior vitrectomy successfully. During follow-up, 28 cases had best corrected visual acuity of more than 4.5. The postoperative inflammation of all cases was slight. There was no hard corneal edema and abiding intraocular pressure higher more than 1wk. The position of the pupil and IOL was normal. <p>CONCLUSION: Anterior chamber injection of TA can make the treatment of posterior capsule rupture and vitreous loss easier, and improve the safety of the traumatic cataract surgery. At the same time, it also can inhibit the postoperative inflammatory reaction.

Clinical observation of endophthalmitis caused by intraocular foreign body injury / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the infection factors,diagnosis and treatment of endophthalmitis after intraocular foreign body injury.METHODS: Totally 256 cases with intraocular foreign bodies including the occurrence of endophthalmitis in 42 cases were analyzed retrospectively.RESULTS: The incidence of endophthalmitis after intraocular foreign body injury was 16.4%.Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury (all P0.05).Vitrectomy was the main treatment of endophthalmitis.CONCLUSION: Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury.It should be kept the integrity of the posterior capsule of lens in traumatic cataract surgery.Intravitreal injection of vancomycin and ceftazidime is recommended in emergency surgery.Vitrectomy should be performed as soon as possible when confirmed endophthalmitis.

A case of perforating injury of eyeball and traumatic cataract caused by acupuncture.

Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58‑year‑old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

Clinical research on efficacy of 25 G vitrectomy for traumatic cataract / 国际眼科杂志(Guoji Yanke Zazhi)

?AIM: To observe the efficacy of 25G vitrectomy for traumatic cataract.?METHODS:Retrospective analysis of 70 cases (70 eyes) of traumatic cataract treated by 25G vitrectomy with lensectomy from February 2013 to February 2015 in our hospital was made for the study.In the patients, there were 43 males ( 43 eyes ) , 27 females ( 27 eyes ) , aged from 22-51 years old with an average of 35.23±2.54 years, mean visual acuity was 0.10±0.03.They were all followed up for 6 -12mo postoperatively. Anterior segment, fundus, complications, best corrected visual acuity ( BCVA ) and intraocular pressure were observed during the follow - up. BCVA preoperatively, 1wk postoperatively, 1 mo postoperatively, 6mo postoperatively were compared.? RESULTS: All the patients underwent the surgery successfully, and visual acuity improved at different degrees. The differences of BCVA preoperatively compared with 1 and 6m postoperatively were all statistically significant ( P <0. 05 ). Postoperative complications:5 cases with corneal edema, 10 cases with ocular hypertension, 4 cases with ocular hypotension, 5 cases with retinal spotting.The symptoms improved after symptomatic and supportive treatment.? CONCLUSION: 25G vitrectomy with lensectomy is effective on treating traumatic cataract, with decreased operation risk, complications and improved visual acuity.

Visual outcome of traumatic cataract in a tertiary care hospital, Tirupati.

Background: The incidence of ocular injuries in India is estimated to be 20.5% affecting mainly those aged less than 40 years and males. Cataract is the commonest complication after ocular injury resulting from either penetrating injuries from sharp objects like stick or thorn or with blunt trauma by objects like stone, cricket ball etc. The present study aims to find out the visual outcome of traumatic cataract cases. Material and methods: This was a cross sectional study conducted among 40 traumatic cataract cases attending outpatient units of SVRR Government General Hospital, Tirupati during July 2014 to June 2015. A predesigned interview schedule was used to collect the necessary information. All patients had undergone Posterior Chamber Intra Ocular Lens Implantation and visual outcome was assessed after 15 days, 6 weeks, 3 months and 6 months. The results were analyzed using MS excel software and Epiinfo 7 version statistical software. Results: It was found that a large majority of the cases were aged less than 40 years (67.5%) and males (62.5%). The most common type of cataract developed was found to be ‘white soft’ type (47.5%). In 52.5% of patients, the time lag between injury and surgery was found to be 1 week to 1 month. It was found that 70% patients had regained vision (>6/18) after surgery. Conclusion: Posterior Capsular Intra Ocular Lens Implantation is highly effective in restoring vision in traumatic cataract cases. The time lag between injury and surgery should be as short as possible for complete recovery. There should be quick referral of traumatic cataract cases to the specialized ophthalmic care units depending on condition of patients.

Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy.

Objective: The objective was to provide evidence‑based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow‑up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome.

Caracterización de los traumatismos oculares severos en la infancia / Characterization of severe ocular traumas in childhood

Objetivo: caracterizar clínica y epidemiológicamente el trauma ocular severo en edad pediátrica. Métodos: se realizó un estudio descriptivo, retrospectivo de serie de casos, en pacientes pediátricos que ingresaron por trauma ocular severo, atendidos en el Servicio de Urgencias y Oftalmología Pediátrica del Instituto Cubano de Oftalmología Ramón Pando Ferrer de enero a diciembre del 2010. La muestra fue de 63 pacientes menores de 19 años de edad, de ambos sexos. Se analizaron diferentes variables demográficas (edad, sexo), y epidemiológicas: evento traumático, agudeza visual grados según puntaje del trauma ocular OTS, tipo de lesión (globo abierto o cerrado) y zona afectada. Resultados: el 81 por ciento fueron varones, y predominó el grupo de edad entre 5 y 9 años (38,1 por ciento ). Hubo un predominio de los traumas cerrados sobre los de globo abierto. Los traumas cerrados se localizaron fundamentalmente en la Zona II, y los abiertos en la Zona I para un 94,3 y 67,8 por ciento respectivamente. Conclusiones: el trauma ocular a globo cerrado particularmente las contusiones localizadas en la Zona II fueron los que más se presentaron. Con relación al pronóstico visual según los valores del OTS hubo gran similitud entre las diferentes categorías y el resultado visual final

Objective: to characterize clinically and epidemiologically the severe ocular trauma at pediatric ages. Methods: a retrospective and descriptive case series study was conducted in pediatric patients, who were admitted to emergency pediatric ophthalmology service of Ramon Pando Ferrer Cuban Institute of Ophthalmology due to severe ocular trauma from January to December 2010. The sample was made up of 63 patients less than 19 years of age of both sexes. The following demographic (age and sex) and epidemiological variables such as trauma event, visual acuity according to the ocular trauma score, type of lesion (open or close eyeball) and affected area were analyzed. Results: in this group, 81 percent were males and the predominant age group was 5 to 9 years (38.1 percent). Close eyeball trauma prevailed over open trauma, the former were mainly located in Zone II, whereas the latter were found in Zone I, accounting for 94.3 percent and 67.8 percent, respectively. Conclusions: ocular trauma of close eyeball-type, mainly contusions placed in Zone II, was the most frequent. As to the visual prognosis according to the ocular trauma scoring, there was great similarity between the different categories and the final visual outcome

Histopathologically proven siderotic cataract with disintegrated intralenticular foreign body.

Cataract formation may be an indicator of early siderosis and has been associated with intralenticular foreign bodies. We report a unique case of histopathologically proven lens siderosis in a young man with a preceding history of trauma but no signs of retained intraocular foreign body. He presented with a total white cataract with brownish deposits on anterior capsule and underwent cataract surgery for same followed by histopathological staining of anterior capsule for iron deposits. This case illustrates the importance of close monitoring of patients with history of trauma or previous penetrating injury to the eye, albeit no intraocular foreign body, as they might develop ocular siderosis at a later stage.

Afecciones traumáticas del cristalino y de la lente intraocular / Traumatic lesions of the crystalline lens and of the intraocular lens

Los traumatismos oculares pueden provocar opacidad secundaria del cristalino, así como la pérdida de su posición anatómica o la de la lente intraocular. Estas son afecciones frecuentes con devastadoras consecuencias si no son atendidas correctamente. Con el desarrollo de las nuevas técnicas quirúrgicas, los resultados anatómicos y visuales de estos pacientes operados son cada día más sorprendentes; pero es mandatorio examinar exhaustivamente al paciente, el abordaje en el momento idóneo y la elección de la técnica quirúrgica adecuada.

Ocular injuries can develop secondary opacity of the crystalline lens as well as the loss of its anatomical position or intraocular lens dislocation. These disorders can frequently lead to devastating consequences if not properly assisted. Recent surgical techniques have dramatically changed the visual prognosis of these patients, achieving amazing anatomical and functional success. However, thorough examination of the patient and the selection of the right surgical time and surgery technique are the keys to attaining good final visual results.

Consideraciones del trauma ocular infantil / Considerations on the ocular trauma in children

Se realizó una descripción de los aspectos clínicos y el manejo terapéutico del trauma ocular en edades pediátricas. Se identifican las particularidades a abordar en estos pacientes con presencia de cataratas traumáticas y/o heridas penetrantes corneales, por las diferencias en el manejo de las mismas en estas edades y en la adultez. Se hace énfasis en el hifema traumático.

The clinical aspects and the treatment management of the ocular trauma at pediatric ages were described. Those particularities to be taken into account when approaching these patients who suffer traumatic cataracts and/or penetrating corneal injuries were indentified, on the account of the differences in the management of this disease between children and adults. Emphasis was made on the description of traumatic hyphema.