Evaluation of different surgical techniques in the management of subluxated cataractous lens.

OBJECTIVE: To compare and evaluate the outcome of different surgical techniques in the management of subluxated cataractous lens. MATERIAL AND METHODS: This retrospective study included 18 eyes of 18 patients with subluxated cataracts of varying etiology. Their preoperative examination maintain included: best corrected visual acuity (BCVA), thorough anterior segment examination, by slit -lamp especially for the degree and extent of subluxation and cataract, cornea, iris and the pupil for other abnormalities or other traumatic signs, presence or absence of vitreous in the anterior chamber, IOP and finally fundus examination. The patients were then divided into 3 groups each comprising 6 patients. The first group underwent ECCE with sulcus implantation PMMA IOL , the second and third groups underwent phacoemulsification with bag implanted Acrylic IOL but the third group underwent special techniques and precautions during surgery. Postoperatively, all patients were examined for BCVA, IOP, IOL positioning, pupil, fundus examination. RESULTS: Thirteen patients were males and five were females. The etiology of subluxation was traumatic in ten males and two female. The ages of the patients were between 11 and 62 years old the post operative follow up period ranged between 7 and 16 months. No major intraoperative complications were noted. In the 1st group 2 patients underwent AC automated vitrectomy, 3 in the 2nd group, 1 in the 3rd group. Three patients needed scleral fixation suture . Thirteen patients had well centered IOL and 4 had slight decentration not necessitating further intervention and one in the 2nd group had clinically significant decentration where IOL explanation, widening of the wound and re implantation of a wide 6.5mm optic PMMA IOL was done in the second post operative daily. CONCLUSION: Subluxated cataracts need special precautions in the chosen surgical technique to maintain a reasonable safety level intraoperatively and an acceptable surgical.

Intraocular foreign bodies associated with traumatic cataract.

OBJECTIVE: To determine prognostic factors and visual outcomes in patients with intraocular foreign bodies (IOFBs) associated with traumatic cataract. PARTICIPANTS: 19 patients undergoing surgical removal of IOFB and cataract extraction with a minimum of 6-months follow-up. OUTCOME MEASURES: Final best corrected visual acuity was the main outcome where ocular findings at presentation were compared with final visual acuity to determine prognostic factors for visual outcome. RESULTS: Final best corrected visual acuity of > 6/30 was obtained in 12 patients (63.2%) and functional vision (> 1.5/60) was achieved in five patients (26.3%). CONCLUSION: Final visual outcomes were found in 63.2% of patients. Initial visual acuity was the strongest predictor of final visual outcome in this study. Additional predictive factors included the mechanism of injury and the presence of vitreous hemorrhage.