Eye trauma requires urgent repair,then reconstruction

In most cases of traumatised eyes, surgeons need to perform primary anterior 

and posterior segment surgeries for the repair of the injuries followed by 

reconstructive surgery as early as possible,  Faruk Nisic MD, Eye Clinic, 

Clinical Center University of Sarajevo, Bosnia and Herzegovina,  

told the 18th ESCRS Winter Congress in Ljubljana, Slovenia. 

He presented three representative cases of a total of 1,216 patients referred to 

his clinic for severe traumatic injuries during the period from April 2012 to April 

2013, at yesterday’s free paper session on Special Cases. 

The first case was an anterior traumatic injury where the nucleus dropped 

into the vitreous cavity. He and his associates first stabilised the lens with the 

27-gauge needle and then performed a lensectomy followed by an anterior 

vitrectomy and clearance of all the vitreous from the anterior chamber and 

pupillary space. Three months later they performed reconstructive surgery. 

First they performed pupilloplasty and then implanted an iris claw lens using 

retropupillary fixation. The patient’s final decimal visual acuity in that eye was 

0.4.

The second case was an open wound injury. There the first priority was closure 

of the wound, which he followed by cataract extraction and implantation 

of standard IOL. He then performed a vitrectomy followed by silicone oil 

tamponade. Two months later they performed pupil reconstruction and the 

patient’s final visual acuity was 0.6.

The last case was a three-year-old child with a serious penetrating injury. The 

patient required reconstruction of the eye wall, removal of lens material from 

the anterior chamber and vitrectomy. Dr Nisic and his associates also implanted 

an iris claw fixated on the iris on one side and the sulcus on the other, with a final 

visual acuity of 0.2.