Combined lensectomy, vitrectomy and scleral fixation of intraocular lens implant after closed-globe injury

Ophthalmic Surg Lasers. 1999 May;30(5):375-81.

Abstract

Purpose: To describe our experience in the surgical management of cataracts in patients with complications of closed-globe injury using pars plana lensectomy (PPL), pars plana vitrectomy (PPV), and scleral fixation of posterior chamber intraocular lens (PCIOL).

Methods: We retrospectively reviewed charts of all patients with closed-globe injury who underwent PPL, PPV and scleral fixation of PCIOL at our institution between January 1991 and July 1997. We identified 28 eyes; because of less than 2 weeks follow-up, 4 eyes were excluded from the current study. All eyes had lens subluxation/dislocation and visually significant cataract. Additional indications for surgery included secondary glaucoma (10 eyes), vitreous hemorrhage (3 eyes) and retinal detachment (1 eye).

Results: The postoperative follow-up interval ranged from 6 to 61 months (mean 18.5 months). Preoperative visual acuity (VA) ranged from 20/60 to hand motion and was 20/100 or better in 6 eyes (25%). Postoperatively, 19 eyes (79%) improved to 20/100 or better. Five eyes had subsequent surgery for the following indications: retinal detachment (2 eyes), poorly controlled glaucoma (2 eyes), and epiretinal membrane formation (1 eye).

Conclusions: In patients undergoing PPL, PPV and scleral fixation of PCIOL for cataract after a closed-globe injury, a substantial visual improvement occurred in a majority of the involved eyes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cataract / etiology
  • Cataract Extraction*
  • Child
  • Eye Injuries / complications
  • Eye Injuries / surgery*
  • Female
  • Glaucoma / etiology
  • Glaucoma / surgery
  • Humans
  • Intraocular Pressure
  • Lens Implantation, Intraocular / methods*
  • Lens Subluxation / etiology
  • Lens Subluxation / surgery
  • Male
  • Middle Aged
  • Orbit / injuries*
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / surgery
  • Retrospective Studies
  • Sclera / surgery*
  • Suture Techniques
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy*
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / surgery*