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   Table of Contents      
ARTICLE
Year : 1983  |  Volume : 31  |  Issue : 5  |  Page : 585-587

Evaluation of lensectomy in traumatic cataract with perforated & non perforated eye injuries


Rotary Eye Institute, Dudhia Talao, Navsari, India

Correspondence Address:
O P Billore
Rotary Eye Institute, Dudhia Talao, Navsari-396 445
India
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Source of Support: None, Conflict of Interest: None


PMID: 6671767

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How to cite this article:
Billore O P, Shroff A P, Dubey A K. Evaluation of lensectomy in traumatic cataract with perforated & non perforated eye injuries. Indian J Ophthalmol 1983;31:585-7

How to cite this URL:
Billore O P, Shroff A P, Dubey A K. Evaluation of lensectomy in traumatic cataract with perforated & non perforated eye injuries. Indian J Ophthalmol [serial online] 1983 [cited 2019 Dec 14];31:585-7. Available from: http://www.ijo.in/text.asp?1983/31/5/585/36596

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Table 5

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Table 4

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Table 2

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Table 2

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Table 1

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Table 1

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The advances in pars plana vitrectomy brought with it something new for the removal of the crystal clear lens or cataractous lens. Lensectomy is performed as a routine during vitrectomy or necessary if opacitification deve­lops due to lens touch. In the present study lensectomy and anterior segment reconstruction were done in 20 cases of traumatic cataract with perforated and non perforated injuries.


  Materials and Methods Top


In the present series 5 cases of perforated eye in­juries and 15 cases of non perforated injuries with traumatic cataract were selected for lensectomy by Peyman's Vitrophage. In 5 cases of perforated injury first corneal or sclerai tear was repaired and abscission of prolapsed iris was done and in the same sitting through pars plana route lensectomy was done. For pars plana lensectomy Peyman's Vitrophage fitted in Dr. Nagpal's vitrectomy console were used.

For lensectomy incision is given 4 mm. from the limbus in upper temporal or lower temporal quadrant. Diathermy is applied to the edge of the sclerotomy in order to make it gape and expose a knuckle of uvea at least 2 mm in length and 1 mm in width. Mattress sutures are passed. A stab wound is made deep into the lens through the equator. An attempt is made with the knife to judge the hardness of the nucleus. Vitrophage tip is passed through the sclerotomy sutures and cutting is begun. The nucleus is removed within the intact bag of the lens and avoiding the anterior and posterior capsules, considerable patience is required to aspirate all the material from the periphery of the lens, after this is accomplished the anterior and posterior capsules are removed. Intra operative complication include loss of cortical material or the nucleus in to the vitreous, cortical material can be easily aspirated, while it is much more difficult to fish for the nucleus. Indirect Ophthal­moscopy is done to see the fundus after lensectomy. Then vitreophage is withdrawn, air is injected and sclerotomy wound is closed.


  Observations Top


The age and sex incidence is shown in [Table - 1].

[Table - 2] shows the injury and the time that lapsed between injury and presentation.

[Table - 3] shows the structures involved.

Visual recovery is shown in [Table - 4]. In perforated injuries visual recovery was good because cases presented early and cataract ex­traction and corneal tear suturing was done in one sitting only. One case had retained foreign body with double perforation. After corneal tear repair and lensectomy indirect ophthal­mology revealed retinal haemorrhage and perforation which was sealed by cryo and sclera was stitched. In perforating injury series 2 cases (40%) recovered vision 6-6 while in non-perforated series 5 cases (60%) recovered 6/6 vision.

[Table - 5] shows the visual recovery in relation to duration of injury.


  Discussion Top


Lensectomy had its origin following the vitreous surgery where little opcification of the lens causes visualization of the vitreous cavity difficult. To overcome the problem posterior lensectomy came into existence. Also in clear lenses opacification develops due to spontaneous touch during vitreous surgery. Hence some workers [1] prefer lensectomy before vitreous surgery and others [2] prefer during vitreous surgery. We have done lensectomy in congenital cataract which prompted us to do lensectomy in traumatic cataract in perforated injury in the same sitting. It was observed that post operative visual recovery in traumatic cataract associated with perforating and non perforating injuries were fairly good. In our series in both the groups visual recovery was up to 6/6 because only lens was involved. In one case perforated injury was due to foreign body which caused double perforation of the globe, wound of entry and exit were closed and retinal tear and haemorrhages were sealed by cryo. 3 cases developed squint due to long standing traumatic cataract. It was further observed that lensec­tomy for traumatic cataract was easy in younger age group and in cases of recent origin. Traumatic cataract of long standing duration had hard nucleus which was difficult to remove and in one case we had to fish out from the vitreous cavity. No doubt anterior segment reconstructions and lensectomy in one sitting gives early visual recovery and prevents squint and amblyopia. If posterior segment is involved then it can be treated in the same sitting.


  Summary Top


In the present study lensectomy and anterior segment reconstruction was done in one sitting and results were fairly good.

 
  References Top

1.
Tolentino F.I., Freeman N.M., Schepens C.L., Closed vitrectomy and lens removal. Vitreous surgery and advances in fundus diagnosis and treatment, 1975.  Back to cited text no. 1
    
2.
Machemer R., Surgery Posterior Lensectorny Vitrectomy A Pars Plana approach by Macherner. New York, Gruve and Stration, 1975.  Back to cited text no. 2
    



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]



 

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