Introduction: We present a patient with perforative eye injury, a metal foreign body in the lens and traumatic cataract. The paper emphasises the importance of phacoemulsification in case of patients with a traumatic cataract and the presence of a metal foreign body.
Case outline: A 41-year-old patient had a perforative wound of the cornea caused by a metal foreign body that also perforated the anterior lens capsule and remained in the paracentral anterior part of the lens. The injury, which happened upon hitting of a hammer against a metal object, showed the presence of a tangential wound of the cornea adapted edges, and a formed anterior eye chamber. The presence of a metal spear-shaped foreign body was partly inside the anterior eye chamber and partly in the central area of the lens. The visual acuity of the injured eye was 0.2. The technique of removing the foreign body out of the lens and the phacoemulsification of the lens with the implantation of intraocular lens is presented. The paracentral wound on the cornea was not sutured because of well-adapted edges. On the first postoperative day there were no inflammatory signs, and best uncorrected visual acuity of 0.8.
Conclusion: Posttraumatic cataracts with a metal foreign body in the lens require operative treatment in order to remove the foreign body, phacoemulsification and implantation of artificial lens. Because of anterior capsule lesion, special care should be taken in regard to anterior capsulorhexis and appropriate hydrodisection. Ocular hypotonia and possible damage of the posterior capsule in some cases can make phacoemulsification more difficult to perform.