Visual outcome of pars plana vitrectomy with intraocular foreign body removal through sclerocorneal tunnel and sulcus-fixated intraocular lens implantation as a single procedure, in cases of metallic intraocular foreign body with traumatic cataract

Abstract

Aim:To evaluate visual outcome following pars plana vitrectomy (PPV) and intraocular foreign body (IOFB) removal through the sclerocorneal tunnel combined with simultaneous cataract extraction and sulcus-fixated intraocular lens (IOL) implantation as a single procedure in penetrating ocular trauma with IOFB and traumatic cataract.Materials and Methods:Eighteen cases of penetrating ocular trauma with retained IOFB and traumatic cataract who underwent PPV, IOFB body removal and cataract extraction with posterior chamber IOL (PCIOL) implantation in the same sitting, between June '04 and December '05 were retrospectively analyzed. All the foreign bodies were removed through the sclerocorneal tunnel.Result:All the 18 patients were young males, with an average follow-up period of 12 months. In 12 cases the foreign body was intravitreal and in six cases it was intraretinal but extramacular. Thirteen cases had a best corrected visual acuity ranging from 20/20 to 20/60 at their last follow-up. Five cases developed retinal detachment due to proliferative vitreoretinopathy (PVR) changes postoperatively and were subsequently managed by surgery.Conclusion:Primary IOL implantation with combined cataract and vitreo-retinal surgery is a safe option reducing the need for two separate surgeries in selected patients with retained IOFB and traumatic cataract. This combined procedure provides good visual outcome with early rehabilitation in young working patients.

Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens

“…If a history of trauma exists, it may not be possible to obtain reliable biometry on the injured eye [1]. Several recent studies suggest that measurements obtained from the uninjured fellow eye may be used in such circumstances [4–5, 7]. …”

“…Sutured scleral fixation involves passing sutures through uveal tissue, which may lead to retinal detachment or intraocular hemorrhage [3, 5, 7–*8, *11, 15, 30]. Risks are higher in myopes, hypertensives, or patients on anticoagulants.…”

Iris Fixation of Unstable Anterior Chamber Intraocular Lenses

“…Also, it is important to note that scleral fixation involves passing sutures through ciliary tissue, which may lead to complications such as retinal detachment or intraocular hemorrhage. [22][23][24][25][26][27] Scleral fixation has also been associated with late IOL dislocation or tilt. 21,25,26,28,29 Moreover, eyes undergoing these surgeries are often compromised with varying degrees of anatomical alterations because of previous trauma and complex surgeries and are therefore more vulnerable to the above-mentioned complications compared with eyes that are naive to intraocular surgery.…”

Perforan göz yaralanmasına ikincil travmatik kataraktlarda katarakt cerrahisi sonuçları

“…Olgularımızın 1'inde 1 ay içinde gelişen retina dekolmanı nedeniyle vitreoretinal cerrahi uygulanmıştır. Retina dekolmanı bu olguların %15-32'sinde görülebilir ve göz içi yabancı cisim varlığı, özellikle genç olgularda gözlenebilen proliferatif vitreoretinopati riski artırır [21].…”