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PHOTO ESSAY
Year : 2017  |  Volume : 65  |  Issue : 10  |  Page : 1019-1020

Anterior capsule rupture: Does this ring, ring a bell?


Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India

Date of Submission19-May-2017
Date of Acceptance31-Aug-2017
Date of Web Publication17-Oct-2017

Correspondence Address:
Parul Ichhpujani
Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_397_17

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  Abstract 


Keywords: Blunt trauma, lens capsule rupture, pars plana vitrectomy, transscleral fixation of the intraocular lens


How to cite this article:
Thakur S, Ichhpujani P, Kumar S. Anterior capsule rupture: Does this ring, ring a bell?. Indian J Ophthalmol 2017;65:1019-20

How to cite this URL:
Thakur S, Ichhpujani P, Kumar S. Anterior capsule rupture: Does this ring, ring a bell?. Indian J Ophthalmol [serial online] 2017 [cited 2020 Feb 16];65:1019-20. Available from: http://www.ijo.in/text.asp?2017/65/10/1019/216755

A 40-year-old Indian female presented to the emergency with a history of ocular trauma with a bicycle handle 2 days earlier. The patient had an uncorrected visual acuity of hand motion close to face and a best-corrected visual acuity of 20/200 with +10D correction.

On slit-lamp examination, the patient was found to be aphakic with anterior capsule of the lens adherent to the endothelial surface of the cornea in the shape of a membranous ring [Figure 1]. The posterior segment was not discernable due to poor media clarity. On ultrasound, a diagnosis of anterior capsule rupture with posterior dislocation of the nucleus was made [Figure 2].
Figure 1: Diffuse illumination of anterior segment revealed 5 mm × 5 mm circular membranous disc on posterior surface of the cornea

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Figure 2: Biconvex lenticular body (red arrow) was seen in the vitreous cavity with no acoustic shadowing behind it, suggestive of nucleus drop on ultrasound

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The patient underwent pars plana vitrectomy for nucleus removal with subsequent scleral fixation of intraocular lens to restore visual acuity [Figure 3].
Figure 3: Three-month postoperative anterior segment picture with best-corrected visual acuity 20/40

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  Discussion Top


Anterior capsule tears are very common after penetrating injuries of the eye but are rare after blunt ocular injuries. A few tears of the anterior lens capsule from blunt injury have been reported.[1],[2] The anterior lens capsule may be torn by direct contusion from rapid focal indentation of the cornea on the lens (coup injury) or by a fluid-mechanical, anteriorly directed rebound of the vitreous, bursting open the anterior capsule (contrecoup injury).[3],[4] In cases where no tears of the posterior capsule or vitreous prolapse occur, visual outcomes are favorable, especially if diagnosed early.


  Conclusion Top


Blunt trauma can result in anterior capsular rupture and posterior dislocation of the nucleus. A ring-shaped membrane on the endothelial surface of the cornea may be a sentinel sign of this condition.

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Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Dezhagah H. Circular anterior lens capsule rupture caused by blunt ocular trauma. Middle East Afr J Ophthalmol 2010;17:103-5.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Gremida A, Kassem I, Traish A. Anterior capsular rupture following blunt ocular injury. Digit J Ophthalmol 2011;17:66-8.  Back to cited text no. 2
[PUBMED]    
3.
Banitt MR, Malta JB, Mian SI, Soong HK. Rupture of anterior lens capsule from blunt ocular injury. J Cataract Refract Surg 2009;35:943-5.  Back to cited text no. 3
[PUBMED]    
4.
Liu X, Wang L, Du C, Li D, Fan Y. Mechanism of lens capsular rupture following blunt trauma: A finite element study. Comput Methods Biomech Biomed Engin 2015;18:914-21.  Back to cited text no. 4
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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