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First Author: P.Gouveia PORTUGAL
Co Author(s): J. Macedo F. Falcao-Reis
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To evaluate the visual outcome of intracapsular extraction of a spontaneously dislocated traumatic cataract three decades after penetrating injury.
Department of Ophthalmology, Hospital São João, Porto, Portugal.
A healthy 50-year old man was observed in the ER for acute loss of vision referred to the right eye. The patient had history of penetrating injury to the right eye at the age of 18 which resulted in a traumatic cataract. He had not consulted an Ophthalmologist since.
On presentation the best visual acuity (BVA) was questionable light perception OD and 20/20 OS. Complete dislocation of the mature cataract to the anterior chamber OD was observed. The intra-ocular pressure (IOP) was 6 mmHg OD and 20 mmHg OS. The patient denied blunt trauma or exertion. A mode B ultrasound revealed a complete and tractional retinal detachment with associated choroid calcifications. An intracapsular cataract extraction was performed. No complications occurred during surgery nor during the postoperative period. Inflammation was controlled with topical corticosteroid and non-steroid inflammatory drug. At one-month postoperative the patient was unable to perceive light OD.
The penetrating injury to the right eye was in all likelihood the causative factor in both the cataract and the retinal defect that precipitated the tractional retinal detachment. Therefore, in this patient, treatment was probably delayed for three decades. A combined surgery with cataract extraction associated with vitrectomy and retinal re-attachment might have resulted in a favorable outcome.