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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.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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