Pupillary capture of implantable contact lens after blunt trauma

Abstract

A 33-year-old woman visited our clinic with blurry vision and periorbital swelling after experiencing blunt trauma to left eye. Ten months earlier, she had implantable contact lens (ICL) implantation in the left eye. Biomicroscopic examination showed that that 1 footplate of the ICL was entrapped in the pupillary aperture at the 7 o'clock position and the ICL was placed vertically. The patient had limited ocular movement in lateral gaze, and the computed tomography showed a medial orbital wall fracture. Pupillary capture of the ICL was surgically corrected with an iris manipulator under topical anesthesia. After the ICL was repositioned, the patient's uncorrected visual acuity was restored to 20/32, as before the injury. Pupillary capture of the ICL may occur after blunt ocular trauma.

Traumatic Dislocation of Implanted Collamer Phakic Lens: A Case Report and Review of the Literature

“…One case report even describes a case in which ICLs were stable after a grenade explosion [6]. Subsequently, there have been five cases of ICL dislocation reported in the literature [7-11], three of which were caused by blunt ocular trauma, similar to ours (Table 1 )[7, 10, 11]. …”

“…There have been three previously reported cases of ICL dislocation caused by blunt ocular trauma [7, 10, 11]. The patients were aged 26, 33, and 39.…”

“…One of the patients was struck by a fist, and the mechanism of injury was not specified in the others. Two of the three reported patients were symptomatic with blurry vision [7, 11]. Interestingly, one of the patients was asymptomatic and the dislocated IOL was only discovered on a regularly scheduled eye exam two weeks after his blunt injury; his vision had decreased to 20/30 from 20/20 [10].…”

“…Interestingly, one of the patients was asymptomatic and the dislocated IOL was only discovered on a regularly scheduled eye exam two weeks after his blunt injury; his vision had decreased to 20/30 from 20/20 [10]. One case reported associated hyphema [11]. In one case the infero-nasal footplate was dislocated [1], in another the infero-temporal footplate [7], and in the third the two temporal footplates were dislocated [10].…”

Traumatic pupillary capture of the haptic of an angle-supported phakic intraocular lens

“…In the former case, disenclavation was responsible for dislocation 3,4 ; in the latter, a soft foldable IOL was forced through the pupil aperture. 5 Unlike iris-fixated and posterior chamber models, angle-supported pIOLs are credited with superior stability in case of trauma because their overall diameter ideally equals the anterior chamber diameter. In this case, the impact of the trauma pushed the distal part of the haptic below the iris plane, resulting in pupillary capture.…”