Participation of Lens Proteins and miRs in Traumatic and Inheritance Cataract: A Review on Diagnostic and Therapeutic Approaches for Cataract Management.

Traumatic and inherited cataract spiking blindness is caused by accumulated deposition of mutant eye lens protein or lens microarchitecture alteration. A traumatic cataract is a clouding of the eye's natural lens that occurs as a result of physical trauma to the eye. This trauma can be caused by various incidents such as blunt force injury, penetration by a foreign object, or a significant impact on the eye area. Inheritance cataracts or hereditary cataracts are cataracts that are genetically inherited from one or both parents. Complications following cataract surgery encompass various adverse outcomes such as inflammation, infection, bleeding, swelling, drooping eyelid, glaucoma, secondary cataracts, and complete loss of vision. The main purpose of the review is to highlight common pathophysiology associated with traumatic and inherited cataracts. Also, the review discusses diagnosis and treatment strategies for such cataract types by targeting their key pathological hallmarks. γD-crystallin plays a crucial role in maintaining the optical properties of the lens during the life span of an individual. Carbamazepine, Resveratrol, and Myricetin (CRM) are effectively bound at the γD-crystallin binding site and thereby could minimize misfolding and aggregation of γD-crystallin. miR-202, miR-193b, miR-135a, miR365, and miR-376a had the highest levels of abundance in the aqueous humor of individuals diagnosed with cataracts. The validation of these miRs will provide more insights into their functional roles and may be used for diagnostic purposes. The effective CRM combination as a multidrug formulation may postpone both traumatic and inherited cataracts and protect the eye from blindness.

Accuracy of 10 MHz ultrasonography for evaluation of posterior lens capsule in traumatic cataract.

PURPOSE: To investigate the performance of 10 MHz ultrasonography in detecting posterior lens capsule defects before traumatic cataract surgery. METHODS: This retrospective analysis includes patients with traumatic cataracts who underwent cataract surgery. Preoperative 10 MHz ultrasonography was performed to evaluate whether the posterior lens capsule was defective or intact, and the results were compared to the intraoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa were calculated. RESULTS: The study included 140 eyes of 140 patients. There were 68 eyes with closed-globe injuries and 72 eyes with open-globe injuries. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa of 10 MHz ultrasonography was 86.76%, 90.28%, 89.39%, 87.84%, 88.57% and 0.771, respectively. The accuracy was 86.11% and 91.18% in open-globe and closed-globe injury groups, respectively. CONCLUSION: The accuracy of 10 MHz ultrasonography in evaluating the posterior lens capsule in traumatic cataracts is high. Preoperative 10 MHz ultrasonography would help to make an appropriate surgical plan.

Management and Outcomes of Traumatic Cataract During Ruptured Globe Repair.

PURPOSE: To compare outcomes of primary lensectomy (PL) versus no lensectomy (NL) during repair of zone I (involving cornea and limbus) and II (up to 5mm posterior to the limbus) ruptured globe injuries (RGIs) with lens involvement. DESIGN: Retrospective clinical cohort study. METHODS: 107 patients with RGIs involving both blunt and penetrating injury to the lens who presented to Wills Eye Hospital between April 1, 2017 and August 31, 2022 were included. Data from presenting visit was collected including demographic information, time from injury to surgery, visual acuity (VA), intraocular pressure (IOP), injury characteristics, and years since residency graduation of surgeon. VA, IOP, retinal detachment (RD) rate, and endophthalmitis incidence were compared between PL and NL groups at postoperative week 1 (POW1) and postoperative month 1 (POM1). VA, peak IOP, need for further surgeries, and types of additional surgery were compared between the two groups at the final visit. RESULTS: 19 (17.8%) patients underwent PL. Age, sex, and initial VA were similar between groups (all p≥0.05). The PL group had surgery later from the time of injury (6.1±14.6 days vs. 1.3±1.9 days; p=0.010), higher IOP at presentation (12.9±11.6 mmHg vs. 7.7±11.3 mmHg; p=0.046), shorter wounds (2.3±1.4mm vs. 4.7±3.2mm; p=0.003), more frequent lens capsule violation (89.5% vs. 50%; p=0.010), increased likelihood of intraocular foreign bodies (52.6% vs. 17.0%; p=0.004), and were more likely to be operated on by surgeons with ≥ 5 years of experience post-residency (68.4% vs. 28.4%; p<0.001). At POW1, the PL group had significantly better logMAR VA (1.2±0.9 vs. 2.0±1.0; p=0.002), and this continued at POM1 (1.0±0.8 vs. 1.6±1.1; p=0.031) and the final visit (0.4±0.7 vs. 1.0±1.1; p=0.010). The PL group had lower IOP at POW1 (12.4±3.0 mmHg vs. 17.3±8.2 mmHg; p=0.005) than the NL group. There was no difference in RD or endophthalmitis rates between the two groups at POW1 or POM1 (p>0.05 for all). The NL group was more likely to require additional surgery by final follow-up (77.3% vs. 47.4%; p<0.001). In the multivariable analysis, PL had better final VA and decreased need for further surgery (both p<0.05). CONCLUSIONS: In the appropriate circumstance, PL during lens-involving anterior RGI repair may lead to improved patient outcomes.

Progressive hyperopic refractive changes after posterior capsule tear following blunt ocular trauma.

Purpose: To describe the mechanism of progressive hyperopia and its management in the long-term course of traumatic cataract with a posterior capsule tear (PCT) following blunt ocular trauma. Observation: A 37-year-old woman presented with blurry vision and photophobia after being hit in the right eye by a slipper. She was found to have PCT with the formation of a traumatic cataract with emmetropia (0 diopters [D]). Three years after the injury, a broader hyperopic change of +8.0 D was found in the patient at her first visit to our clinic. Optical coherence tomography (OCT) analysis of the anterior segment of the eye revealed damage to the posterior capsule and cataracts due to disorganization of the lens fibers and liquefaction of the lens. Femtosecond laser-associated cataract surgery was performed for anterior capsulotomy and segmentation of the nucleus without further enlargement of the PCT, facilitating the placement of a capsular tension ring segment and a multifocal intra ocular lens (IOL) in the capsular bag. At 1-month post-operation, her uncorrected visual acuity was 20/20 in the right eye, with a well-centered IOL. Conclusions and Importance: Isolated PCT due to blunt trauma is rare, and there have been no reports of progressive hyperopia after three years of follow-up. In such cases, the lens may liquefy, resulting in decreased refraction and significant hyperopia.

Traumatic cataract induced by improper use of a percussion massage gun.

Purpose: We describe a case of traumatic cataract after improper use of a percussion massage gun over the periorbital area. Observations: A 38-year-old female with a history of high myopia and fibromyalgia presented to the emergency department with painless monocular vision loss OS, noticed two days prior and described as a "white film" over her eye. BCVA was 20/20 OD and 20/600 OS. IOP was normal. Slit lamp examination OS showed a dense posterior subcapsular cataract in a rosette pattern without signs of zonular instability. B-scan ultrasonography showed a clear vitreous cavity without structural globe anomalies. No other abnormalities were apparent. After ruling out other causes, vision loss was attributed to development of a traumatic cataract secondary to percussive massage gun use over the left temple and periorbital area, including directly over the eye, during the past few weeks as an attempt to relieve intractable headaches. Conclusion and importance: Improper use of massage guns can lead to severe ocular side effects including traumatic cataracts that may be difficult to manage. There is a need to educate patients about potential harms as well as require manufacturers to clearly display safety information.

Características del trauma ocular en pacientes diagnosticados con catarata traumática / Characteristics of Ocular Trauma in Patients Diagnosed with Traumatic Cataract

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 por ciento) y la mayoría de los casos presentaron un trauma ocular cerrado (70,4 por ciento). El ojo derecho fue más afectado (64,8 por ciento). En cuanto al lugar de ocurrencia del traumatismo ocular, el 49,9 por ciento 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(AU)

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 percent) and the majority of cases presented blunt ocular trauma (70.4 percent). The right eye was more affected (64.8 percent). Regarding the place of occurrence of ocular trauma, 49.9 percent 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(AU)

Brown McLean syndrome after congenital glaucoma surgery, unique case report and a literature review.

Purpose: Brown-McLean Syndrome (BMS) was first documented by Brown and McLean in 1969. To date, BMS is typically described in primarily cataract-related complications, and it is inextricably associated with long-term aphakia. Our purpose is to report a case that describes a unique association of BMS in the presence of patent peripheral iridectomy. Observation: A 35-year-old male known case of congenital glaucoma who has a history of bilateral trabeculectomy, presented to our clinic with a long history of mild progressive blurriness of vision for years. Upon examination, the patient was bilaterally phakic, with bilateral 360-degree of peripheral corneal edema sparing the center of the cornea with endothelial pigmentation and bilateral patent peripheral iridectomy in an otherwise stable ophthalmic examination. His uncorrected visual acuity was 20/20 in the right eye and 20/30 in the left eye with normal intraocular pressure. Our plan was to prescribe topical medications and schedule him for regular follow-up. At the last follow-up, our patient reported no improvement in his vision, and there were no signs of clinical improvement. Conclusion and importance: This case of BMS demonstrates the importance of the potential of such a disease to develop, albeit rarely, in phakic patients who are undergoing intraocular surgery. The preventive role of PI is also questionable. Categories: Ophthalmology, Pediatrics, Transplantation.

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. Video link: https://youtu.be/Vwp1qUh1Mrc.

Metallic intralenticular foreign body removal without crystalline lens extraction: a case report.

We describe a technique for metallic intralenticular foreign body (ILFB) removal in a patient in whom there was no or minimal cataract formation or other complications. This technique required creating two corneal small incisions around the ILFB for inserting iris retractors to expose the ILFB. At the foreign body position, a clear corneal incision was made, and then the ILFB was removed with minimal manipulation by an intraocular magnet without complications. Because most occupational traumas occur in young people, this technique avoids the adverse outcomes of lens extraction in this age group.

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.

Paediatric traumatic cataracts in Southwest China: epidemiological profile.

BACKGROUND: Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China. METHODS: The medical records of children (age range, 0-14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed. RESULTS: A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) - induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2-8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001). CONCLUSION: The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.

Pediatric traumatic cataracts: 10-year experience of a tertiary referral center.

BACKGROUND: This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. METHODS: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications. RESULTS: In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures. CONCLUSIONS: In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.

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. ONLINE VIDEO LINK: https://youtu.be/-axYnSfWSb0.

Visual outcomes of open globe injury patients with traumatic cataracts.

PURPOSE: Open globe injury (OGI) is a serious form of ocular trauma that can significantly lower quality of life post-injury due to comorbidities. This study was designed to investigate how traumatic cataracts and other pre-operative variables affect visual outcomes of OGIs. METHODS: A retrospective review was conducted for OGI patient records with presence of traumatic cataracts, visual outcomes, comorbidity data and provider training. Multivariable logistic regression analysis determined if several pre-operative variables including traumatic cataracts, retinal detachment and hyphema were predictive of final visual acuity and need for retinal surgery. Ancillary multivariable analysis was conducted to evaluate if timing of traumatic cataract extraction predicted poor final visual acuity. RESULTS: Multivariable logistic regression analysis did not find traumatic cataract to be an independent predictor of final visual outcome in the open globe injury sample population (n = 102, p = 0.386), but did find retinal detachment (p = 0.008), hyphema (p = 0.035) and scleral laceration (p = 0.009) to be independent predictors of poor final visual acuity. In the subgroup of eyes with traumatic cataract (n = 64), delayed cataract extraction was not found to be an independent predictor of poor final visual acuity (p = 0.156). CONCLUSION: Our results suggest that retinal detachment, hyphema, and scleral laceration influence final visual outcome while traumatic cataract does not. Within the subpopulation of patients that received lens extraction, timing of extraction was not found to independently influence final visual acuity.

Role of Scheimpflug imaging for assessment of posterior lens capsule in pediatric traumatic cataract.

PURPOSE: To find the accuracy of Scheimpflug imaging for the evaluation of posterior lens capsule and to assess the incidence of pre-existing posterior capsular tear (PCT) in pediatric traumatic cataracts. METHODS: It was a prospective, non-randomized, and interventional study. Scheimpflug imaging was done preoperatively to detect pre-existing PCT in pediatric traumatic cataracts after blunt trauma. All patients underwent cataract extraction with intraocular lens implantation. Intraoperatively, the posterior capsule status was noted and compared with the preoperative Scheimpflug images. RESULTS: Forty-seven eyes of 47 children having traumatic cataracts following closed-globe injury were included. There were 32 males and 15 females with a mean age of 10.91 ± 2.75 years. The mean duration of performing the Scheimpflug imaging from injury was 41.7 ± 7.78 days. Preoperative Scheimpflug imaging showed intact posterior lens capsule in 36 eyes and PCT in 11 eyes. Intraoperative, 37 eyes had an intact posterior lens capsule and 10 eyes had PCT. The Scheimpflug imaging did not detect the PCT in three eyes (false-negative), and in four eyes, PCT was detected falsely on Scheimpflug imaging (false-positive). The sensitivity and specificity of the Scheimpflug imaging were 70 and 89.18%, respectively. The accuracy of the technique was 85.11%. CONCLUSION: Scheimpflug imaging is a useful modality for the detection of PCT preoperatively in cases with doubtful posterior lens capsule integrity.

Traumatic Cyclodialysis Cleft Treatment Combined with Cataract Surgery: An Original Triple Procedure.

INTRODUCTION: To describe a "triple" surgical procedure, which combined traumatic cataract extraction by phacoemulsification with gas endotamponade and cyclocryotherapy in the successful treatment of a traumatic cyclodialysis cleft. METHODS: A 44-year-old man who suffered severe left eye blunt trauma with an elastic band developed a 4-hour extent cyclodialysis cleft with consequent hypotony. After 7 weeks of persistent hypotonic maculopathy unresponsive to medical treatment, and with an evolving traumatic cataract, the patient underwent cataract surgery combined with intravitreal gas endotamponade (20% SF6) and cyclocryotherapy. RESULTS: Two weeks after the procedure the intraocular pressure increased to 12 mmHg and remained steady during the next 14 months of follow-up. Hypotonic maculopathy resolved and successful closure of the cyclodialysis cleft was confirmed by gonioscopy and ultrasound biomicroscopy. CONCLUSION: Gas endotamponade and cyclocryotherapy constitute a promising option in the treatment of cyclodialysis clefts unresponsive to medical therapy. In our case, this minimally invasive technique was innovatively combined with cataract surgery. Despite early postoperative intraocular inflammation, a successful outcome was achieved.

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)

Isolated posterior capsule rupture after blunt eye injury.

Isolated posterior capsule rupture of the crystalline lens after blunt eye injury is a rare complication and demands a special surgical management strategy in order to achieve a good visual outcome.

BILATERAL EYE INJURY WITH BILATERAL BLOWOUT FRACTURE CAUSED BY A HIGH-PRESSURE WATER JET IN 16-YEARS-OLD FIREMAN GIRL. CASE REPORT.

PURPOSE: The aim is to present a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in a 16-year-old girl during a competition for young firefighters. METHODS: We present a case report of a 16-year-old female patient with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blowout fractures of orbits.  Results: The initial ocular examination revealed "hand motion" in the right eye and no light perception in the left eye. Intraocular pressure was low in both eyes. Motility of both eyes was reduced, especially in the left eye. Lacerations of the eyelids and conjunctiva required a surgical procedure. No repair of the upper canaliculus of the left eye was attempted. Paralytic mydriasis and loss of lens accommodation in both eyes did not change throughout the follow-up period. A surgical procedure was applied to resolve the left blowout fracture, ocular motility of the right eye improved spontaneously. Traumatic cataract developed in the left eye within 1 year after injury, requiring cataract surgery and posterior capsule lens implantation, the right lens remained clear. Massive scarring of the retina and choroid in the lower parts of the eyes and in the macula reduced best corrected visual acuity in the right eye to 0.15 and in the left eye to 0.08. Intraocular pressure is within normal limits without any glaucoma therapy. The follow up period is three years. CONCLUSION: This is the first reported case of child with an eye injury caused by a high-pressure water jet during a sports activity.