Traumatic Cataract Removal With Suture Fixation Of The Entire Iol-Capsular Bag Complex And Iris Reconstruction

To reduce the time of surgical rehabilitation of patients with traumatic cataract, lens subluxation and iris defects

S.N. Fedorov NMRC “MNTK “Eye microsurgery” 

65 y.o. man presented with a traumatic cataract, crystalline lens subluxation, loss of zonular support, distorted pupil, iris stromal atrophy and binocular vision disorder after a severe left eye contusion. Preoperative features, preoperative and postoperative corrected distance visual acuity, intraoperative performance, IOL position, and complications were evaluated. Preoperative visual acuity in the involved eye was accurate light projection. The intraocular pressure was normal. We performed a phacoemusification with an implantation of the posterior chamber IOL in the capsular bag, capsular tension ring implantation, pupilloplasty, and fixation of the IOL - capsular bag complex with the use of zig – zag scleral suturing by Szurman. The uncorrected visual acuity in the immediate postoperative period was 20/25. The intraocular pressure was normal. Slit lamp biomicroscopy revealed a stable position of the IOL – capsular bag complex with no evidence of IOL displacement. At the last follow-up 12 months after the combined surgery all the parameters were stable.

It has been proven that combined surgery of traumatic cataract with scleral stitching of the IOL – capsular bag complex and pupilloplasty in patients with traumatic cataract and lens subluxation allows to obtain high visual functions and rapid rehabilitation of these patients.  Combined microsurgery can be considered a safe and effective method of the traumatic cataract treatment.