Visual outcome of traumatic cataract surgery in Ibadan, Nigeria.

OBJECTIVE

To review the visual outcome of traumatic cataracts operated at the University College Hospital, Ibadan with the view to making recommendations for improved outcome.

METHODS

All patients operated at the University College Hospital Ibadan, Nigeria between May 1999 and April 2004 with traumatic cataract were reviewed retrospectively to determine visual outcome and main causes of poor visual outcome <6/18, using a structured data entry form and information obtained from the operation register and case notes of patients

RESULTS

32 patients, age range 2 to 71 years, mean age 25.6 +/- SD 16.1 years were reviewed. 22 (68.8%) were males while 10 (31.2%) were females. Causes of traumatic cataract included wood/stick splinters in 7 (21.9%), cane/whiplash injury 6 (18.8%), and propelled missile injuries, 5 (15.6%). Less important cause of injuries were gun shot, road traffic accident and fist injuries. 11 (35.6%) of the patients had best corrected post operative visual acuity of >6/18, 10 (32.2%) <6/18-3/60, while 32.2% of the cases reviewed remained blind or had vision <3/60 in the affected eye. Cause of poor post operative visual acuity (less than 6/18) in 64.4% of the subjects included cornea opacity 12.5%, posterior capsule opacity 12.5%, retinal detachment 9.4%, and glaucoma 6.9%.

CONCLUSION

Useful vision can be restored in a proportion of traumatic cataracts through surgery, although sight-limiting complications, which may be related to the severity of the trauma or prolonged post op inflammation may be present, many are potentially treatable with further intervention. The need for adequate health education to prevent ocular injuries and preoperative diagnosis of associated posterior segment complications that may prevent optimal post-operative visual acuity is also noted.