Primary repair and intraocular lens implantation after perforating eye injury.
OBJECTIVE
To evaluate the clinical outcome after primary treatment of lens injuries with corneal or corneoscleral trauma.


METHODS
Ten eyes of 10 patients were retrospectively evaluated. There were no foreign bodies in any eye. After primary repair, an anterior chamber maintainer (ACM) was introduced through the inferotemporal corneal quadrant. Sodium hyaluronate 1.4% (Healon GV(R)) was injected, and the anterior capsule was stained with trypan blue 0.1% vital stain (Vision Blue) under the viscoelastic substance. After a capsulorhexis was created, the lens material was aspirated. The nucleus was delivered from the scleral tunnel, which was opened from the superior/superotemporal corneal quadrant. A conventional 21.0 diopter poly(methyl methacrylate) intraocular lens (IOL) with a 5.5 mm optic and overall diameter of 12.5 mm (Dr. Schmidth(R), Hannan Kibbutz) was implanted through the scleral tunnel. The scleral tunnel was not sutured, and the corneal entry sites were closed with stromal hydration.


RESULTS
The final best spectacle-corrected visual acuity (BSCVA) was better than 20/100 in all patients, and 6 patients had a BSCVA of 20/20. The IOL was in the capsular bag in all patients at the last follow-up. The mean follow-up was 12.3 months (range 7 to 25 months). The main visually limiting factors were corneal scar, irregular astigmatism, and traumatic maculopathy.


CONCLUSIONS
Primary IOL implantation in carefully selected patients with penetrating corneoscleral lens injury may yield visually rewarding results. The use of a vital stain to increase the visibility of the injured anterior capsule and of a closed scleral tunnel system with an ACM increased the surgical safety.
Baykara
Mehmet
M
Department of Ophthalmology, Uludag University School of Medicine, Bursa, Turkey. mehmetbaykara@hotmail.com
Dogru
Murat
M
Ozçetin
Hikmet
H
Ertürk
Haluk
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000187:drug effects; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D065306:Corneal Injuries; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D012189:Retrospective Studies; D012590:Sclera / Q000293:injuries*; D014343:Trypan Blue; D014792:Visual Acuity
D006820:Hyaluronic Acid; D019904:Polymethyl Methacrylate; D014343:Trypan Blue