Successfull Management Of Trauma Induced Aphakia In Eccentric Pupil Condition : A Case Report

This case report aims to inform about secondary IOL implantation and pupilloplasty as the management of trauma induced aphakia in eccentric pupil eyes.

This case report was conducted at one of the ophthalmology referral center in indonesia.

A 22 Years old female was admitted to Saiful Anwar Hospital Eye Clinics due to blurry vision on the right eye since 10 years before admission. There was a history of right eye got penetrated with her own broken sunglasses during road accident 10 years ago. On Ophthalmic examination, the visual acuity in the right eyes was 1/300 and the left eyes was 20/20. Examination on the right eye revealed aphakia and extremely eccentric pupil in the 9 o'clock direction blocking the visual axis. Apahakic and eccentric pupil condition of the right eyes is presumably related with open globe injuries of the right eyes 10 years ago. No abnormalities were found on retina and optic nerve of both eyes from funduscopic examination.

The patient underwent a secondary IOL implantation and pupilloplasty in the right eye. During the surgery, it was revealed that the pesterior capsule was still intact so the operator chose to place the IOL in the bag. Pupilloplasty was done by cutting the iris to the center of visual axis without any specific iris suture technique. The surgical procedure successfully restored the visual acuity into 20/20 after 7 days post-operative. After 3 months of follow up the visual acuity remained 20/20 with no sign of complication.

This case report shows a management of trauma induced apahakia and eccentric pupil with secondary IOL implantation and simple pupilloplasty technique. The procedure successfully restores the visual function of the patient.