CLINICAL CASE OF TRAUMATIC CATARACT SURGERY WITH LENS SUBLUXATION AND FUSED IRIDOCORNEAL SCAR

Published 2022 - 26th ESCRS Winter Meeting

Reference: P061 | Type: Abstracts | DOI: 10.82333/t93g-yy27

Authors: Sergey Sakhnov ¹ , Oksana Nabatova* ² , Denis Nefedov ² , Tamriko Zakaraiia ³

¹Department of Administration,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation, ²Department of Surgery,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation, ³Department of Science,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation

Purpose

The patient had suffered a penetrating corneal injury at the age of 5 years. No surgical intervention was performed. During the course of life, the patient's best corrected visual acuity was 10/30. He came to the clinic at the age of 70 (65 years since the injury). At the time of examination, he was found to have accurate projection of light in all directions. Before mydriatic instillation, the pupil was not visualized and the iris was stretched in a solid "sail" by 5 o'clock, into the limbal scar. The aim of the intervention was to restore the patient's accustomed visual acuity.

Setting

Clinical case conducted at the S Fyodorov Eye Microsurgery Federal StateInstitution - Krasnodar, Russia.

Methods

The decision has been made to perform cataract phacoemulsification with monofocal IOL implantation and iris plastics with pupil shaping.

Results

The surgery was performed with application of iris retractors to the pupil margins. The lens ligament apparatus was incompetent and there was rather significant phacodonesis, therefore anterior capsulorhexis was not easily performed, after which the retractors were moved to the edges of the capsulorhexis. The intracapsular ring was implanted. After hydrodissection was performed, phacoemulsification of the cataract was performed. The crystalline lens nucleus was very dense and viscous, which made it difficult to destroy. Capsular sac was fully preserved. After washout of cortical masses, the intraocular lens prepared for implantation was stitched at the base of both arches with 8.0 polypropylene thread, one end of which was fused with electrocautery to form a fixation flange on the lower surface of the lens. The IOL was then implanted into the capsular bag with an injector. And sclerocorneal suturing according to Kozhukhov - Telegin was performed. The next stage was isolation of iris section, soldered into limbal scar and joining of resulting flaps by nodal sutures with formation of pupil.

Conclusion

Even 65 years after an eye injury, it is reasonable not to limit treatment to the phacoemulsification of a cataract, but to restore the anatomical correspondences by performing iris plastics to achieve a satisfactory visual acuity. As a result of the intended surgical intervention, the patient regained his habitual visual acuity: 10/30. The patient was satisfied with the result.