First Author: P.Kra?nicki POLAND
Co Author(s): J. Konopi?ska E. Skr?tek Z. Mariak
Purpose:
The aim of the paper is to present the case of complicated cataract removal after perforating ocular trauma with the presence of foreign body in the anterior segment of the eye.
Setting:
67-year-old patient was admitted to the Ophthalmology Department of the University Hospital in Bialystok in order to remove traumatic cataract of the left eye. The patient complained of decreased vision acuity of the left eye present for about half a year, with periodic pain and redness, which resolved spontaneously without any treatment. 25 years ago he experienced the trauma of this eye. When tapping with a hammer a small piece of metal hit him in the eyeball. Patient failed to go to an ophthalmologist. At the date stated: acuity of the left eye was 0.2, intraocular pressure was 13 mmHg. The examination revealed corneal scar after perforating wound of approximately 3.00 mm at 12- approximately 1.5 mm from the limbus of the cornea. Anterior chamber was deep and clean. The metallic foreign body 1,5 x 2,5 mm in size, covered by fiber and rust was placed into the iris at 12. Pupil somewhat irregular with presence of a point posterior synchea at 12, was in the center, with a normal reaction to light. The status of the lens was the initial nuclear cataract and the wedge, white opacities in the plan of a foreign body in the cortex.
Methods:
At the first stage of operative procedure phacoemulsification of cataract with simultaneous implantation of artificial intraocular lens was performed. Next, the foreign body with an adjacent iris tissue was removed. The iris was sawn up with two single stitches 10/0.
Results:
On the first day after surgery VA was 1.0 without any correction, IOP was 15 mmHg. The eye was slightly irritated. The cornea presented single DescemetÂ’s membrane folds and scar due to wound after foreign body penetration. The anterior chamber was deep and the aqueous fluid was clean. At 12 a slight lack of iris was visible at the base. The pupil was a little bit irregular, quite narrow, with stapled sphincter at 12. The IOL was properly fixed.
Conclusions:
1.Metallic foreign body in the anterior chamber of the eye does not have to lead to the development of endophthalmitis.
2.It is hard to estimate whether the periodic pain and redness of the eye was caused by chemical or mechanical irritation of the iris by foreign body.
3.Phacoemulsyfication of the cataract completed by pupilloplasty after foreign body and adjacent iris tissue removal is an effective therapeutic option in such cases. FINANCIAL DISCLOSURE?: No
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