Dealing With Subluxated Traumatic Cataract
Published 2023 - 41st Congress of the ESCRS
Reference: PO0312 | DOI: 10.82333/fe26-m062
Authors: Miroslav Stamenkovic* 1 , Jovan Milic 1 , Milos Plavsic 1 , Aleksandra Popovic 1 , Nebojsa Nikitovic 1 , Zoran Zikic 1 , Miroslav Stamenkovic* 1
1Eye Clinic,University Medical Center Zvezdara,Belgrade,Serbia
To report clinical evaluation and treatment of patient with subluxated traumatic cataract. A 61 year-old male patient presented with a history of blunt trauma to the right eye while chopping wood. Initial best corrected visual acuity (BCVA) on injured eye was 1/60. Further examination revealed subluxated traumatic cataract with “sunset” sign, with moderate zonular dehiscence and vitreous extension into the anterior chamber.
Intraoperatively major phacodonesis was noted. After creating main incision, capsulorexis and gentle hydrodissection were done. The capsulotomy margin was then utilized to centralize the crystalline lens for phaco and minimize the risk of further vitreous prolapse through the zonular dehiscence
Clinic for Eye Disease “Prof. dr Ivan Stankovic” University Medical Center
“Zvezdara”.
The small volume of vitreous extending through the zonular dehiscence and into the anterior chamber was pushed back with the use of viscoelastic. Two iris hooks were inserted through the peripheral cornea to support the capsule margin. Gentle hydrodissection was achieved with BSS. Before commencing phacoemulsification, the capsule periphery in the area of the dehiscence was secured with a CTR and a 10–0 polyprolene suture temporarily secured via the limbus. After that phacoemulsification with low flow and power was performed with subsequent cortex aspiration. The capsular bag was completely clear of cortical material and filled with viscoelastic. An PC IOL was injected in the capsular beg.
The CTR was repositioned and temporary suture removed via the limbus.
First postoperative day there was no evident corneal oedema, pupil was regular and IOL was well positioned without tilt. Subsequently regular controls were made at 3,6,9 and 12 months. On those control exams BCVA, IOP control and fundus examination were performed. BCVA after one year was 0,8.
Traumatic subluxated cataracts can be successfully treated with standard phacoemulsification followed by implantation of CTR. Although there are other surgical options for treating this kind of problem, we believe that phacoemulsification with CTR implantation is superior method due to excellent postoperative results and low risk of intraoperative and postoperative complications.