Management of the traumatic cataract during ruptured globe repair at Wills Eye Hospital: a comprehensive retrospective review

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Talia N. Shoshany, MD
Ava Torjani, BA
Qiang Zhang, PhD
Zeba Syed, MD

Abstract

Introduction
This study aims to compare outcomes of primary lensectomy (PL) versus no-primary lensectomy (NPL) in ruptured (RG) repair.
Methods
Retrospective review of anterior RGs with lens involvement presenting to the Wills Eye ER between 2017-2022. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), endophthalmitis and retinal detachment (RD) incidence, and need for additional procedures were compared between PL and NPL groups at POW1, POM1 and final visit.
Results
Out of 107 patients with lens involvement, 19 (18%) received PL and 88 did not. There were no differences in age, sex, BCVA, IOP, zone of injury, visual axis involvement, anterior chamber or retinal status between groups at presentation (P ≥ 0.05). PL group had shorter laceration length, higher incidence of IOFB and lens capsule violation, and were more likely to be operated on by a surgeon with >5 years of experience (P ≤ 0.01). BCVA was better in PL group at POW1, POM1 and final visit (P ≤ 0.03). NPL group had higher IOP and was more likely to require glaucoma drops postoperatively. Rates of endophthalmitis and RD were similar between groups. Need for additional surgery was higher in NPL group (P ≤ 0.03); 50% of NPL group required lensectomy within the 90-day post-op period and 24% by final visit. There were no differences in corneal transplant rates, but NPL group required more vitrectomies (P = 0.03). In a subanalysis of lens capsule violation only (n = 61, 28% PL), results were similar to full the cohort analysis; 30% of NPL group required lensectomy within 30-days, 66% within 90-days, and 82% by final visit.
Conclusions
In the appropriate circumstance, primary lensectomy should be considered a safe option and may lead to better patient outcomes in anterior ruptured globes with lens involvement.

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How to Cite
1.
Shoshany TN, Torjani A, Zhang Q, Syed Z. Management of the traumatic cataract during ruptured globe repair at Wills Eye Hospital: a comprehensive retrospective review. Digit J Ophthalmol. 2024;30. Accessed July 21, 2024. https://djo.harvard.edu/index.php/djo/article/view/1097
Section
Abstracts