Extended focal length intraocular lens implantation in posttraumatic posterior capsular rupture

Abstract

We present a case of posterior capsular defect with traumatic cataract after blunt trauma in which an extended focal length intraocular lens (IOL) was implanted in the bag after conventional phacoemulsification and anterior vitrectomy. Anterior segment optical coherence tomography performed preoperatively aided in the confirmation and documentation of the capsular integrity. Intraoperative trocar anterior chamber (AC) maintainer allowed AC maintenance without further complications. IOL was well centered postoperatively at 6 months, and the unaided visual acuity was 20/20 for distance and N8 for near. The report showed that an extended depth of focus IOL can be placed in eyes with ruptured posterior capsule for good visual outcome in posttraumatic young eyes and it may not be considered as a relative contraindication for it.

Case report: Spontaneous Expansion of an Isolated Posterior Capsule Rupture

“…In the past, bimanual irrigation/aspiration (I/A) through two paracentesis stab incisions was employed for children with preexisting posterior capsule defects [7] . Another safe approach involves the removal of crystalline cortex using a high vacuum and low ow rate mode of phacoemulsi cation [8,9] . In our case, the latter method was utilized, aligning with the preferences of the cataract surgeon.…”

“…In our case, the latter method was utilized, aligning with the preferences of the cataract surgeon. Anterior vitrectomy is typically performed intraoperatively in cases of isolated PCR when vitreous prolapses into the anterior chamber [7][8][9] . However, cases with PCR but intact vitreous may not necessitate anterior vitrectomy [6,10] .…”

“…Additionally, the shape of the ruptured posterior capsule is spindle-shaped, suggesting the possibility of radial tearing. Previously, isolated PCR was described as having an oval shape [9] . Describing it as spindle-shaped may provide a more accurate characterization.…”

Clinical Outcomes with Extended Depth of Focus Intraocular Lenses in Cases in Which Multifocal Lenses Are Not Primarily Recommended

“…To this date, very few studies have been conducted to evaluate the potential of EDOF IOLs for providing a successful visual restoration in those cases which the indication of multifocal IOLs is risky and not fully accepted [20][21][22]. Te aim of the current study was to evaluate the visual and patient-reported outcomes of patients undergoing cataract surgery with implantation of an EDOF IOL who were not good candidates for multifocal IOL implantation due to one of the following conditions (common exclusion criteria of studies evaluating the outcomes of trifocal difractive IOLs): patients operated on with a monofocal IOL in the fellow eye, previous corneal refractive surgery with excimer laser, mild and nonprogressive maculopathy, mild and nonprogressive glaucoma, age over 75 years, amblyopia, or previous vitrectomy.…”

Commentary: Presbyopia correction with intraocular lenses

“…Recent advances in multifocal intraocular lenses (IOLs), Trifocal IOLs, and extended range of vision IOLs have revolutionized the outcomes of cataract surgery. [ 2 ] With advent of these lenses, now the cataract surgery has expanded into the realm of refractive surgery. [ 3 ]…”