VISUAL REHABILITATION OF POST-TRAUMATIC IRREGULAR ASTIGMATISM

Corneal irregularity, whether primary (keratoconus) or, as here secondary to corneal wound, is a source of qualitative or even quantitative visual deficits.

The corneal topography plays a crucial role in guiding the adaptation to a rigid lens, the only one capable of effectively and safely erasing major irregularities of the anterior corneal diopter.

In giant corneal astigmatisms, semi-scleral lenses can represent a temporary solution while waiting for the time of the transplant, or even an alternative to the transplant if the result is satisfactory.

ophthalmology department; August 20th,1953 hospital Ibn Rochd University Hospital Center Faculty of Medicine and Pharmacy Casablanca Hassan II University (Morocco) 

Our patient was received in the emergency in March 2021 for transfixing corneal wounds of the left eye with ruptured post traumatic cataract, following a self-trauma by a scalpel.

The emergency care was carried out in two stages:

1st step: Closure of the wound after iris reintegration and careful washing of the anterior chamber.

2nd step: Surgery of the ruptured cataract with rupture of the capsular plane, by simple irrigation-suction and implantation in the SULCUS.

Parameterization of the rigid gas permeable lenses (RGP):

Neutralization of irregular and major asymmetric corneal astigmatism can only be done by an RGP with Large diameter: to improve comfort and large optical area to optimize optical benefit.

Causes of post traumatic corneal irregularity : Healing of the southern stromal incision

or linked to the destructuring effect of the deep southern incision on the stromal architecture.

In irregular corneas, the scleral lens can restore a uniform surface and thus correct vision by creating a uniform surface with a better success rate than with glasses.

 

This unusual case illustrates the interest and the rules for adapting post-traumatic irregular corneas by scleral glasses.

And above all to never lose hope in the quest for visual perfection by non-surgical means, especially in our Moroccan context where the corneal transplant applicant is faced with long waiting lists.