Extended focal length intraocular lens implantation in posttraumatic posterior capsular rupture

Abstract

We present a case of posterior capsular defect with traumatic cataract after blunt trauma in which an extended focal length intraocular lens (IOL) was implanted in the bag after conventional phacoemulsification and anterior vitrectomy. Anterior segment optical coherence tomography performed preoperatively aided in the confirmation and documentation of the capsular integrity. Intraoperative trocar anterior chamber (AC) maintainer allowed AC maintenance without further complications. IOL was well centered postoperatively at 6 months, and the unaided visual acuity was 20/20 for distance and N8 for near. The report showed that an extended depth of focus IOL can be placed in eyes with ruptured posterior capsule for good visual outcome in posttraumatic young eyes and it may not be considered as a relative contraindication for it.

Keywords: Extended depth of focus; extended focal length intraocular lens; posterior capsule rupture; traumatic posterior capsule tear.

Figure 1

Diffuse (a) and slit image (b) showing the posterior capsule defect after blunt trauma with posterior subcapsular cataract

Figure 2

Anterior segment optical coherence tomography showing the defect in posterior capsule (circle)

Figure 3

Trocar anterior chamber maintainer fixed (a) and cortex removed (b) followed by extended depth of focus intraocular lens implantation (c)

Figure 4

Postoperative slit lamp picture on day 1 (a), 1 month (b), and 12 months (c)

Figure 5

Postoperative ultrasound biomicroscopy at 12-month postsurgery showing no tilt and good centration and stability of intraocular lens