Posterior capsule rupture, iridodialysis, hyphema, and macular hole after blunt ocular trauma.
A 34-year-old man was examined 4 hours after blunt ocular trauma with a stone. Visual acuity was hand motions in the right eye and 10/10 in the left eye. Slit-lamp examination after resorption of a hyphema revealed 180◦ superior iridodialysis and a total white intumescent cataract precluding visualization of the posterior capsule. Phacoemulsification was undertaken after repositioning the iris with microretractors. Intraoperatively, we discovered that the cen-tral portion of the posterior capsule presented a 4-mm oval opening with thick and fibrosed edges. The posterior chamber lens was safely implanted in the bag with no enlargement of the posterior capsule rupture. Postoperatively, VA improved only to 1/20 and fundus OCT revealed the presence of a 400-micron, oval-shaped macular hole that was successfully closed with sub-sequent vitrectomy and gas tamponade. Visual acuity stabilized at 5/10, D3, and the lens was stable without decentration after 36 months follow-up.
A
A
Sayen
J B
JB
Conart
J P
JP
Berrod
D000328:Adult; D006801:Humans; D006988:Hyphema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007499:Iris Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D057852:Posterior Capsule of the Lens / Q000293:injuries* / Q000601:surgery; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012421:Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000601:surgery