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Abstract #25270 Published in IGR 12-1
Management of traumaticcrystalline lens subluxation and dislocation
Salehi-Had H; Turalba AInternational Ophthalmology Clinics 2010; 50: 167-179
Lens subluxation and zonular damage after ocular trauma is a relatively common occurrence. The current phacoemulsification techniques used for routine cataract surgery may be suboptimal for the safe and efficient removal of symptomatic subluxed lenses or traumatic cataracts. The surgeon needs to conduct a careful preoperative examination of all eyes with a history of trauma and note the status of the zonules. Many options exist for propermanagement of zonular dialysis, and they all hinge on the surgeons ability to identify zonular compromise and the extent of lens instability preoperatively. A variety of capsular support devices are currently available to the anterior segment surgeon for the management of mild-to-moderate lens instability and zonular compromise of up to 180 degrees. With more severe, global lens instability, a posterior segment approach with pars plana vitrectomy and lensectomy is advised. Complete lens dislocation into the vitreous cavity may be managed conservatively and surgery may be delayed, especially if the lens capsule has not been compromised. However, if the patient develops glaucoma, persistent uveitis, symptoms uncorrectable with refraction, or anterior dislocation of the lens, then surgical removal is needed.
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
Classification:
9.4.4.3 Glaucomas associated with lens dislocation (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
9.4.7 Glaucomas associated with ocular trauma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
