Original Research

Axial length elongation in adults with long-standing unilateral traumatic cataract

Jonel Steffen, Nagib du Toit, James C. Rice, Shaheer Aboobaker
African Vision and Eye Health | Vol 75, No 1 | a334 | DOI: https://doi.org/10.4102/aveh.v75i1.334 | © 2016 Jonel Steffen, Nagib du Toit, James C. Rice, Shaheer Aboobaker | This work is licensed under CC Attribution 4.0
Submitted: 17 November 2015 | Published: 28 September 2016

About the author(s)

Jonel Steffen, Groote Schuur Hospital, University of Cape Town, South Africa
Nagib du Toit, Groote Schuur Hospital, University of Cape Town, South Africa
James C. Rice, Groote Schuur Hospital, University of Cape Town, South Africa
Shaheer Aboobaker, Groote Schuur Hospital, University of Cape Town, South Africa


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Abstract

Background: Unilateral eye elongation with resultant axial myopia has been reported to occur secondary to visual deprivation from birth or early childhood. Acquired axial length elongation secondary to visual deprivation in adults has rarely been reported.

Aim: To report acquired axial myopia in adults with visual deprivation due to long-standing unilateral traumatic cataract.

Methods: Eleven consecutive adult patients who presented for cataract surgery with unilateral, long-standing, mature, traumatic cataracts and an interocular axial length difference of more than 1 mm were studied. Patients with a post-operative best corrected visual acuity (BCVA) of < 6/12 were excluded to rule out possible pre-existing anisometropic amblyopia.

Results: Of the 11 patients with significant interocular axial length difference, 5 patients were excluded on the basis of possible pre-existing amblyopia. The remaining 6 patients had final BCVA of 6/12 or better. The median length of the cataractous eyes was 2.83 mm longer than the fellow eyes (range 1.12 mm – 3.52 mm). The intraocular lens power required for emmetropia was 6.8 dioptres (range 3.5 dioptres – 11.5 dioptres) less in the cataractous eyes. A refractive outcome within 1 dioptre of the target refraction was achieved in all patients. The median delay between ocular trauma and cataract surgery was 20 years (range 8–24 years).

Conclusion: Significant unilateral axial length elongation may occur in adults with longstanding traumatic cataracts and visual deprivation. A potential correlation may exist between delay to surgery and degree of axial length difference. This rare phenomenon must be considered when determining intraocular lens power to avoid post-operative refractive surprises.


Keywords

Cataract [C11.510.245]; Myopia [C11.744.636]; Eye Injuries [C11.297]

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