Phacoemulsification In Traumatic Cataract With Lens Subluxation And Phacodonesis

Traumatic cataracts represent a surgical challenge as they are often associated with zonular instability which can be obvious or occult. The purpose of this case report is to present a case of traumatic cataract with minimal dislocation and phacodonesis. 

Department of Ophthalmology, General Hospital of Lamia, Lamia, Greece.

A 78 years old farmer presented with cortical cataract with minimal phacodonesis. The patient reported a blunt ocular trauma several years before. Anterior segment examination after mydriasis revealed slight lens  tilt. The patient underwent cataract surgery and iris retractors were used to stabilize the capsule through capsulorrhexis at the site of presumed zonular traumatic rupture. After phaco a capsular tension ring was inserted and intraocular lens was inserted in the bag.

At the follow up examinations during the first month the intraocular lens showed absolute centration without pseudophacodonesis.

Partial zonular rupture may be present in traumatic cataracts and proper instrumentation (iris retractors, capsular tension ring) is necessary  to overcome any unexpected situations. However, in the absence of pathologic zonnular instability (such as in pseudoexfoliation) the rest of the zonules may be adequate to ensure intraocular lens stability and centration.