Combined lensectomy, vitrectomy and scleral fixation of intraocular lens implant after closed-globe injury.
OBJECTIVE
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.
Chaudhry
N A
NA
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL, USA.
Belfort
A
A
Flynn
H W
HW
Tabandeh
H
H
Smiddy
W E
WE
Murray
T G
TG
D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D005131:Eye Injuries / Q000150:complications / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007906:Lens Subluxation / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000293:injuries*; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*