Pars Plana Vitrectomy in Treatment of Lens Injury

Remzi  Avcı; Sami  Yılmaz

doi:10.4274/tjo.43.40427

ABSTRACT

Lens injury due to traumas may present as loss of capsule integrity, cataract, lens subluxation, or lens luxation. In addition, lens subluxation and lens luxation may occur in pseudophakic patients due to trauma. Clear corneal, scleral or sclero-corneal phacoemulsification surgery, pars plana vitrectomy, pars plana vitrectomy with phaco-fragmentation, or pars plana vitrectomy with removal through corneal incision techniques are used in the treatment of lens injury due to traumas. Intraocular lens can be implanted in the bag, sulcus, or anterior chamber during the surgery. Depending on the circumstances, scleral fixated intraocular lenses or iris-claw lenses may also be preferred. Rehabilitation of such patients is not of a great concern today, with the advanced level of vitreoretinal surgery and cataract surgery techniques and with the current state of technology.

Keywords:

Lens subluxation, lens luxation, pars plana vitrectomy, trauma

References

Saika S, Kin K, Ohmi S, Ohnishi Y. Posterior capsule rupture by blunt ocular trauma. J Cataract Refract Surg. 1997;23:139-40.

Lee SI, Song HC. A case of isolated posterior capsule rupture and traumatic cataract caused by blunt ocular trauma. Korean J Ophthalmol. 2001;15:140-4.

Yasukawa T, Kita M, Honda Y. Traumatic cataract with a ruptured posterior capsule from a nonpenetrating ocular injury. J Cataract Refract Surg. 1998;24:868-9.

Marcus DM, Topping TM, Frederick AR Jr. Vitreoretinal management of traumatic dislocation of the crystalline lens. Int Ophthalmol Clin. 1995;35:139-50.

Omulecki W, Synder A, Stolarska K. Removal of luxated crystalline lenses by intravitreal phaco-emulsification. Klin Oczna. 2002;104:377-80.

Yao K, Shentu X, Jiang J, Du X. Phacofragmentation without perfluorocarbon liquid for dislocated crystalline lenses or lens fragments after phacoemulsification. Eur J Ophthalmol. 2002;12:200-4.

Zhang HJ, Dong JY, Jin K, Wang GH, Xu da L, Huo M. Efficacy of Removing Dislocated Lens using Intravitreal Phacoemulsification. Yan Ke Xue Bao. 2012;27:34-6.

Praveen MR, Vasavada AR, Singh R. Phacoemulsification in subluxated cataract. Indian J Ophthalmol. 2003;51:147-54.

Girard LJ, Canizales R, Esnaola N, Rand WJ. Subluxated (ectopic) lenses in adults: Long-term results of pars plana lensectomy-vitrectomy by ultrasonic fragmentation with and without a phacoprosthesis. Ophthalmol. 1990;97:462-65.

Morrison D, Sternberg P, Donahue S. Anterior chamber intraocular lens (ACIOL) placement after pars plana lensectomy in pediatric Marfan syndrome. J AAPOS. 2005;9:240-2.

Chakrabarti A, Gandhi RK, Chakrabarti M. Ab externo 4-point scleral fixation of posterior chamber intraocular lenses. J Cataract Refract Surg. 1999;25:420-6.

Baykara M, Ozcetin H, Yilmaz S, Timuçin OB. Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am J Ophthalmol. 2007;144:586-91.

Hakin KN, Jacobs M, Rosen P, Taylor D, Cooling RJ. Management of the subluxed crystalline lens. Ophthalmology. 1992;99:542-5.

Omulecki W, Stolarska K, Synder A. Phacofragmentation with perfluorocarbon liquid and anterior chamber or scleral-fixated intraocular lens implantation for the management of luxated crystalline lenses. J Cataract Refract Surg. 2005;31:2147-52.

Wesołek-Czernik A, Omulecki W, Chrul E, Synder A. Phacofragmentation with perfluorocarbon liquid and anterior chamber or scleral-fixated intraocular lens implantation for the management of luxated crystalline lenses-long-term results. Klin Oczna. 2007;109:191-3.

Dalma-Weiszhausz J, Franco-Cardenas V, Dalma A. A modified technique for extracting a dislocated lens with perfluorocarbon liquids and viscoelastics. Ophthalmic Surg Lasers Imaging. 2010;41:572-4.

Oh J, Smiddy WE. Pars plana lensectomy combined with pars plana vitrectomy for dislocated cataract. J Cataract Refract Surg. 2010;36:1189-94.

Flynn HW Jr, Buus D, Culbertson WW. Management of subluxated and posteriorly dislocated intraocular lenses using pars plana vitrectomy instrumentation. J Cataract Refract Surg. 1990;16:51-6.