Visual Outcomes And Prognostic Factors Following Traumatic Cataract Surgery In Children Aged 2–8 Years: A 5-Year Prospective Study

Published 2026 - 44th Congress of the ESCRS

Reference: FP15.05 | Type: Free paper | DOI: 10.82333/sbeg-py86

Authors: Dr Xiaohuan Zhao* ¹ , Dr Jin Yang ¹

¹Ophthalmology,Eye and ENT Hospital, Fudan University,Shanghai,China

Purpose

Traumatic cataract during the amblyogenic period can lead to long-term visual impairment, yet prospective data on recovery and modifiable prognostic factors are limited. We aimed to characterise 5‑year visual trajectories and identify prognostic factors after surgery in children aged 2–8 years.

Setting

Prospective multicenter cohort study.

Methods

Patient demographic information, surgical characteristics, and follow-up data were extracted. Best-corrected visual acuity (BCVA) and refractive astigmatism from 1 week to 5 years following traumatic cataract extraction were collected. Independent factors influencing BCVA at 5 years postoperatively were analyzed using logistic regression models, while the impact of amblyopia training on BCVA over the 5-year period was assessed using the Kaplan-Meier method.

Results

Among 333 injured eyes (mean age 5·13 years; 222 [66·7%] boys), BCVA improved markedly over follow‑up, with greatest gains within the first 2 years. Younger age at injury was associated with poorer 5‑year visual outcomes. Injury severity and corneal involvement were major determinants of long‑term BCVA. In open‑globe injuries, delayed primary repair and poor amblyopia therapy adherence were linked to poorer prognosis. Good adherence to amblyopia therapy was associated with improved long‑term BCVA in closed‑globe (OR 0·29, 95% CI 0·01–0·97) and open‑globe injuries (OR 0·41, 95% CI 0·22–0·77), including among children with severe corneal injury and those injured before 7 years of age.

Conclusions

Younger age at surgery (<4 years) demonstrated progressive improvement in BCVA throughout the 5-year follow-up period, while those aged ≥4 years achieved visual stability by 2 years after surgery. Favorable long-term visual outcomes were significantly associated with smaller corneal wound size and shorter injury-to-primary repair time. Strict adherence to amblyopia therapy conferred substantial visual benefits, particularly in children injured before the age of 7. These findings support implementing comprehensive management strategies including early primary repair, systematic amblyopia intervention, and long-term regular postoperative follow-up to optimize visual prognosis.