Unilateral axial length elongation with chronic traumatic cataracts in young Kenyans

Abstract

PURPOSE: To assess whether unilateral axial elongation in chronic traumatic cataract is associated with the time interval from trauma to surgery. SETTING: PCEA Kikuyu Hospital Eye Unit, Nairobi, Kenya. METHODS: This retrospective cohort study analyzed patients with traumatic cataract operated on between 1998 and 2007. Study patients (n Z 13) had a delay from trauma to surgery of more than 1 year and an interocular axial length (AL) difference greater than 1.0 mm. Randomly selected age-matched control patients (nZ14) had less than 1 year delay between trauma and surgery. The correlation between interocular AL difference and surgical delay was calculated in each group. RESULTS: The median interval from trauma to surgical treatment in study patients was 8 years (range 1 to 27 years). Study patients had a significantly higher median interocular AL difference (3.09 mm; interquartile range [IQR] 2.45 to 4.13 mm) than control patients (0.24 mm; IQR 0.15 to 0.30 mm) (P Z .000). The length of delay from trauma to surgical treatment did not correlate strongly with the interocular AL difference in study or control patients (R2 Z 0.0143 and R2 Z 0.1697, respectively). CONCLUSIONS: Unilateral AL elongation may occur in young adults with chronic traumatic cataract. Delay of more than 1 year from trauma to surgery was associated with axial elongation, although the degree of elongation did not correlate with duration of delay. Surgeons are advised to implant lowerpower intraocular lenses in such patients based on biometry readings to avoid postoperative refractive surprises.