Primary Flanged Belt-Loop Transscleral Fixation Of The Optical Part Of The Toric Iol In A Young Patient After Traumatic Cataract Extraction

Provide a stable position of the Toric IOL using one of the techniques of transscleral fixation in order to prevent rotational instability and subluxation.

Traumatic cataract may develop due to penetrating and blunt ocular injuries. This type of cataract is common among youth and children.

The plenty amount of cause can lead to cataract development, but mostly it depends on field of activity, age moreover condition of life. As known lens are highly sensitive, so that any damage lead to formation of cataract. It must be noted that mostly lens capsule could be involved into the process. Obviously the chosen treatment approach is surgery.

A 35-year-old male presented with significant visual decrease in the left eye due to blunt force trauma.UCVA at the time of examination was 20/100 in the left eye. IOP was 14 mm Hg in OS. Patient underwent a full ophthalmology examination. Based on instrumental methods of diagnostics he was diagnosed as a case of traumatic cataract, moderate myopia with myopic astigmatism.

Needed Toric IOL calculation was made by Reytrace Premium IOL Calculator taking into account IOL Master and Pentacam parameters such as AXL – 27 mm, ACD – 2.93, K1 – 33.3, K2 – 36.3, that gave us IOL proposal – for model 61OT (Rayner) SE + 20.0 D, sphere – 18.0 D, cylinder – 4.0 D. Taking into account all given parameters has been decided to carry out cataract surgery with implantation of Toric IOL. After phacoemulsification of cataract CTR  above the last Toric lens have been implanted.  Next day on slit lamp exam was found decentration of IOL, caused by defect at equatorial part of the capsular bag. We decided to perform another operation related to transscleral fixation as we identified that state. Second operation regarding to flanged belt-loop transscleral fixation of optic part, on the projection of  Toric IOL marks in parallel to the targeted axis of astigmatism notched at 155° on cornea then toric marker was used to ensure IOL alignment.

On the first day of postoperative review the UCVA of the OS was 20/40. A slit lamp examination throughout drug-induced mydriasis showed correct central lens position.

The above described flanged belt-loop transscleral fixation of Toric IOL method in case of the absence of capsule support or significant capsule rupture provides central position stability and improvement of visual acuity with reducing period of rehabilitation. Given method is technically accessible for implementation and less traumatic.