Unilateral axial length elongation with chronic traumatic cataracts in young Kenyans

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 = 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 (n = 14) 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 = .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 = 0.0143 and R² = 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 lower-power intraocular lenses in such patients based on biometry readings to avoid postoperative refractive surprises.