ESCRS - PO0149 - Multiple Intraocular Surgeries From Anterior To Posterior Segment In A Post-Traumatic Eye

Multiple Intraocular Surgeries From Anterior To Posterior Segment In A Post-Traumatic Eye

Published 2023 - 41st Congress of the ESCRS

Reference: PO0149 | Type: Case report | DOI: 10.82333/x9sz-5d90

Authors: Huri Sabur* 1 , Ayse Tufekci Balıkcı 2 , Gulizar Demirok 2 , Dicle Oncel Hazırolan 2 , Zuleyha Yalniz Akkaya 2 , Ayse Burcu 2

1Ophthalmology,University of Health Sciences, Diskapi Research and Training Hospital,Ankara,Türkiye, 2Ophthalmology,University of Health Sciences, Ankara Research and Training Hospital,Ankara,Türkiye

To present the history of a traumatic case who underwent multiple intraocular surgeries following blunt trauma from childhood to adulthood.

University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkiye

A 42-year-old male who had a history of blunt trauma was referred to our clinic for persistent corneal edema. He had a history of multiple ocular surgeries, including lensectomy for traumatic cataract, C-loop anterior chamber IOL implantation, and strabismus surgery twice. On examination, the left eye was normal with a visual acuity of 20/40 and an intraocular pressure (IOP) of 19 mmHg. The visual acuity of the right eye was ‘hand motions’, and the IOP was 44 mmHg. The biomicroscopic examination of the left eye revealed corneal edema, an anterior chamber IOL, proliferated lens material encapsulated in the capsular bag, and an optic disc atrophy. Topical corticosteroids, 5% NaCl, preservative-free artificial tears, and anti-glaucoma drops (dorzolamide-timolol 2x1, brimonidine tartrate 2x1) were prescribed, and the IOP was regulated. After three months of normal IOP, the anterior chamber IOL was removed, a capsular bag containing lenticular material was extracted, and a seconder IOL implantation by the Yamane technique combined with pupilloplasty was performed. However, some cortex pieces dropped into the vitreous, and pars-plana vitrectomy was needed. In addition, due to intractable high IOP and severe pain, an Ahmet glaucoma valve implantation, and for corneal decompansation a Descemet membrane endothelial keratoplasty (DMEK) were performed. Unfortunately, despite all surgeries, visual acuity didn’t improve due to optic atrophy.

Traumatized eyes may develop various ocular problems such as cataracts, glaucoma, and corneal decompensation over time and can need multiple ocular surgeries. Although DMEK surgery is currently the most preferred method for restoring corneal transparency, some patients may not have satisfying visual acuity due to optic atrophy caused by chronically elevated intraocular pressure.