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¹Eskişehir Osmangazi Üni. Tıp Fak. Göz Hast. A.D., Eskişehir, Doç. Dr.
²Eskişehir Osmangazi Üni. Tıp Fak. Göz Hast. A.D., Eskişehir, Yrd. Doç. Dr.
³Eskişehir Osmangazi Üni. Tıp Fak. Göz Hast. A.D., Eskişehir, Prof. Dr.
⁴Eskişehir Osmangazi Üni. Tıp Fak. Göz Hast. A.D. Başkanı, Eskişehir, Prof. Dr. Purpose: To compare the clinical outcome of penetrating traumatic cataract cases that underwent simultaneous penetration repair with intraocular lens (IOL) implantation or penetration repair followed by cataract extraction with IOL implantation in a second session.
Materials and Methods: Eighteen eyes of 18 patients with primary IOL implantation (Group 1, mean age 36.4±7.9 years) and 23 eyes of 23 patients with secondary IOL implantation (Group 2, mean age 31.9±8.9 years) were retrospectively evaluated. There were no foreign bodies or posterior capsule perforation in any of the eyes. In Group 1, after primary repair, extracapsular cataract extraction was performed. Monoblock polymethylmethacrylate IOL was implanted and the power calculation was performed according to the fellow eye. In Group 2, cataract extraction was performed with phacoemulsification two months after the primary repair. Postoperative findings were evaluated in the first week every day, in the first month every week, and then every month until the sixth month after surgery.
Results: The mean follow-up was 18.8±4.2 months in Group 1 and 20.8±5.9 months in Group 2. Thirteen eyes in Group 1 and 17 eyes in Group 2 achieved a final spectacle-corrected visual acuity of 20/40 or better, and 5 eyes in Group 1 and 8 eyes in Group 2 achieved 20/20 visual acuity. The major causes of limited visual acuity were central corneal scars, irregular astigmatism, posterior capsule opacification, and traumatic maculopathy. Fifteen eyes in Group 1 and 9 eyes in Group 2 developed posterior capsule opacification.
Conclusions: Cataract extraction and IOL implantation with primary repair in selected patients with penetrating injury may provide visually satisfying results. However, the posterior capsule opacification rate was higher in cases in which cataract extraction with IOL implantation was performed in a second session. In ideal cases, secondary cataract extraction and IOL implantation after penetrating ocular trauma may be preferable, with low refractive error and a low rate of postoperative complications. Keywords : Lens injury, cataract extraction, intraocular lens, repair