Guideline considerations for management of paediatric traumatic cataract
Reviewed by Fiona Rowe

This study aimed to develop guidelines for preoperative decision-making and perioperative management of paediatric traumatic cataract patients. A 24-question survey was designed to assess surgeon background, preoperative planning and testing, surgical timing, intraoperative techniques and postoperative management. Anonymous responses were received from 56 clinicians; 35 in academic hospitals and 21 in private practice with referrals from outside providers, from within their practice or from emergency departments. Most (49) would perform ruptured globe repair. Only 4% would remove the traumatic cataract at the time of globe repair if there was no obvious anterior capsule violation, increasing to 42% if the anterior capsule was violated. This reduced to 28% if there was concern for delayed presentation and / or dirty mechanism of globe injury. Fifty-one percent had a preference to remove visually significant cataracts within four weeks of trauma if the child was <7 years old, reducing to 29% if older in age. Eighty-two percent would obtain B scan ultrasound at the initial evaluation if there was a limited fundus view. Intracameral antibiotics would be used by 61% and steroids by 37.5%. Generally there was a lack of consensus on most surgery questions highlighting the need for standardised guidelines. This warrants a multicentre trial to focus on ideal timing for cataract extraction, IOL insertion and amblyopia treatment. 

Practice patterns in the surgical management of pediatric traumatic cataract.
Zhu AY, Kraus CL.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2020;57:190-8.