Management of Pediatric Traumatic Cataract With An Open Globe Injury

Levandi Mulja, Mayasari Wahyu, Irawati Irfani, Primawita Oktarima


Introduction: Traumatic cataract is one of the leading causes of monocular blindness in children. The management of pediatric traumatic cataract is challenging; the growing size of the affected eyes and the risk of amblyopia further complicate things. The timing of cataract removal and IOL implantation remain controversial until today.

Case Report: A thirteen-years-old boy came with his left eye punctured by a pencil tip. He came in with a visual acuity of 1/300, a full-thickness 5 mm paracentral corneal laceration and traumatic cataract. The patient went through a two-step surgery. Cataract surgery and IOL implantation was conducted one week following corneal laceration suture.

Discussion: Two-step surgery was performed on this patient with consideration being cataract removal performed when the inflammation of the eye was subside and also a more accurate IOL calculation. One study stated, even with 43.4% of patient’s anterior capsule ruptures, it would postponed cataract surgery for 2 days up to 6 months. In this case, a week after first surgery, it revealed anterior capsule rupture and the lens material was touching corneal endothelium. Therefore, lensectomy was performed because it touches the corneal endothelium causing further damage

Conclusion: The two-step procedure performed was a preferable surgery for a traumatic cataract in a quiet eye, because it has better potential for visual improvement and IOL calculation. However, since the anterior lens capsule ruptured and the lens material prolapsed into the anterior chamber, it would have been even better to perform lensectomy as an early procedure to prevent inflammation.


1. Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: A review of the literature. J Emerg Trauma Shock 2015; 8(4): 216-223.
2. Gogate P, Sahasrabudhe M, Shah M, Patil S, Kulkarni A. Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India. Ind J of Ophthalmol 2012; 60(5): 481-6
3. Reddy AK, Ray R, Yen KG. Surgical intervention for traumatic cataracts in children: Epidemiology, complications, and outcomes. J AAPOS 2009; 13: 170-174
4. Shah M, Shan S, Agrawal J, Khanna R, Rathod C. Controversies of traumatic cataract in children. EC Pediatrics 2018; 35-47.
5. Tabatabaei SA, Rajabi MB, Tabatabaei SM, Soleimani M, Rahimi F, Yaseri M. Early versus late traumatic cataract surgery and intraocular lens implantation. Eye 2017;1-6
6. Sen P. Shah C, Sen A, Jain E, Mohan A. Primary versus secondary intraocular lens implantation in traumatic cataract after open-globe injury in pediatric patients. J Cataract Refract Surg 2018; 44(12): 1446- 1453.
7. Ciloglu E, Unal F. Surgical approach to pediatric traumatic cataract. EC Ophthalmology 2018; 9 (3): 143- 147.
8. Salvin JH. Systematic approach to pediatric ocular trauma. Curr Opin Ophthalmol 2007; 18:366-372
9. Kinori M, Tomkins-Netzer O, Wygnanski-Jaffe T, Ben-Zion I. Traumatic pediatric cataract in southern Ethiopia- results of 49 cases. J AAPOS 2013; 17: 512-515.
10. Burgos-Elias VY, Marroquin-Sarti J, Zimmermann-Paiz MA, Rivaz AM,Quezada-del NC. Traumatic cataract surgery in pediatric patients. Experince in a site. Arch Argent Pediatr 2018; 116(3): 216-223.
11. Xu YN, Huang YS, Xie LX. Pediatric traumatic cataract and surgery outcomes in eastern China: a hospital-based study. Int J Ophthalmol 2013; 6(2): 160-164.
12. Shah MA, Shah SM, Appleware AH, Patel KD, Rheman RM, Shikhange KA. Visual outcome of traumatic cataract in pediatric age group. Eur J Ophthalmol 2012; 22(6): 956-963.
13. Yardley A, Ali A, Najm-Tehrani N, Mireskandari K. Refractive and visual outcomes after surgery for pediatric traumatic cataract. J Cataract Refract Surg 2018; 44: 85-90.
14. Kuhn F. Ocular traumatology.Berlin. Springer. 2008. Hal 245- 268
15. Steinert RF. Cataract Surgery. Techniques and principle of surgical management for the traumatic cataract. Edisi ke-3. California. Elsevier Saunders 2011. Hal 351-68
16. Adhikari S, Shrestha UD. Pediatric cataract surgery ith hydrophilic acrylic intraocular lens implantation in Nepalse children. Clinical ophthalmology 2018; 12: 7-11.
17. Ram J, Sukhija J. Pediatric cataract surgery: current concepts. JIMSA 2010; 23(3): 132-137.


Levandi Mulja
Mayasari Wahyu
Irawati Irfani
Primawita Oktarima
Mulja, . L., Wahyu, M., Irfani, I., & Oktarima, P. (2023). Management of Pediatric Traumatic Cataract With An Open Globe Injury. Ophthalmologica Indonesiana, 48(2), 97–104.

Article Details

No Related Submission Found