Complicated Traumatic Cataract Surgery

To demonstrate a surgical video of a cataract surgery with Intraocular lens implantation on a post traumatic cataract eye.

A 35 year old male individual presented with right eye diminution of vision. He had history of trauma to the eye with a metallic wire 7 months back. On examination visual acuity was Hand movement close to face with accurate perception of light. In the right eye self sealed corneal perforation was noted with a central corneal scarring. There were multiple posterior synechia with an intumescent white cataractous lens. Other eye was within normal limits.

B scan of the right eye was grossly anechoic.

The patient was planned for right eye cataract surgery under explained prognosis. 

The surgery was performed under peribulbar anesthesia. After giving a corneal incision with a microkeratome blade, synechiolysis was performed using viscoelastic substance. Iris hooks were introduced to perform mechanical mydriasis. On attempting capsulorhexis an extension of capsulotomy margin was noted. Intravitreal scissors and forceps were used to complete the capsulorhexis. Using a co-axial irrigation aspiration probe the instumescent component was aspirated. Phacoemulsification was then performed in a controlled manner to avoid damage to the posterior capsule. Finally an intraocular lens was placed.

On post operative day 1, the patient had a visual acuity of 6/12 unaided which further improved to 6/9 on pin hole. The intraocular pressure was 16mm of mercury. There was mild corneal edema at the incision site, intraocular lens was stable in the bag and the fundus revealed normal disc and foveal reflex.

In traumatic cataracts the likelyhood of intraoperative complications are very high. However, when managed properly it can yield excellent results.