Case Of Refractive Errors Accompanied By Ocular Trauma Corrected By Toric Implantable Collamer Lenses

The text reports a successful implantation of a TICLs (V4c) in a patient with refractive error and adhesive corneal leukoma. The implant was positioned obliquely to avoid the area of trauma. The procedure achieved the desired refractive outcome, and the TICLs remained stable throughout the follow-up period.

A 25-year-old female patient with refractive error associated with a history of old ocular trauma presented to Chengdu Aidi Eye Hospital seeking refractive surgery to remove her glasses. She had a history of a penetrating injury to the left eye. Examination revealed adhesive corneal leukoma, pupillary distortion, and localized punctate opacities in the lens of the injured eye.

A 25-year-old female patient presented with a history of a penetrating injury to her left eye (treatment details unavailable). 

Examination:

Uncorrected Visual Acuity (UCVA): Right eye (R): 0.06, Left eye (L): 0.3

Intraocular Pressure (IOP): R 15 mmHg, L 16 mmHg

Refraction:R: -9.00 = 1.0, L: -4.75/-4.25*65 = 0.8

The left eye exhibited temporal adhesive corneal leukoma, keyhole-shaped pupillary distortion, punctate pigment deposits on the lens surface, and localized lens opacity. The central anterior chamber depth was adequate. Gonioscopy revealed a normal angle (N1) except the site of adhesion. The right eye appeared unremarkable with an angle width of N1.

Corneal Diameter: R: 11.7 mm, L: 12.0 mm

Corneal Curvature: R: 41.82/42.40*67, L: 39.30/42.65*0

Endotheliumendothelial cell count (ECD): R: 3054 cells/mm², L: 2685 cells/mm²

Ultrasound Biomicroscopy (UBM) revealed marked anterior synechiae with leukoma and no abnormalities of the ciliary body or angle recession.

Surgical Plan:

R:  TICL V4c 12.6 mm-10.00, orientation: 15° off the horizontal. L(traumatic eye): TICL (V4c) 13.2 mm-10.00/+4.50/090, orientation: 65° off the horizontal.

Postoperative Observations:

Day 1:UCVA:R: 1.0, L: 0.8; IOP: R: 15 mmHg, L: 15 mmHg; vault: R: 601 μm, L: 376 μm; 

1 Month: R: 1.2, L: 1.0; IOP: R: 16 mmHg, L: 18 mmHg; vault: R: 522 μm, L: 392 μm; ECD: R: 2896 cells/mm², L: 2543 cells/mm². 

6 Months:R: 1.2, L: 1.0; IOP: R: 15 mmHg, L: 15 mmHg; vault: R: 510 μm, L: 363 μm.

The stability of TICLs depends on the stability of the posterior chamber structure.
The placement angle of TICLs is not a determining factor for postoperative rotation.
Following a comprehensive evaluation, the implantation of TICLs may also be considered for cases of anterior segment trauma.