Abstract

This was a report about a pseudophakic patient who experienced isolated total aniridia without damage to other intraocular structures following blunt trauma to the eye. This patient had a history of uneventful cataract surgery using a small clear corneal incision (CCI). This 71-year-old male presented at our clinic with glare in his left eye. He reported that he had fallen down while drunk and struck his left eye against a stone on the road 15 days earlier. He had undergone cataract surgery on his left eye nine months before the accident at another eye clinic. Slit-lamp examination showed total aniridia in his left eye, but there was no hyphema or cells in the anterior chamber. The intraocular lens in his left eye was stable, without decentration, dislocation, or zonular dehiscence and remained in an intact capsular bag. Review of the medical records from the surgical clinic at which he had undergone cataract surgery indicated no specific findings for any intraocular structure including the iris. He had previously undergone an uneventful phacoemulsification for his left eye through a 2.2 mm CCI, followed by the implantation of a single piece acrylic intraocular lens inside an intact capsular bag. This report showed that small-sized CCIs can be opened postoperatively by trauma and that this can result in isolated total aniridia without damage to other intraocular structures.

Highlights

  • The advances in cataract surgery have made small, self-sealing clear corneal incisions (CCIs) a standard surgical technique

  • There have been few reported cases of total aniridia caused by blunt trauma in pseudophakic patients who have undergone phacoemulsification using a CCI since the first report in a patient with a 4.0-mm sized incision and the implantation of a multipiece intraocular lens (IOL)(2)

  • A previous report had described total aniridia in patients who had undergone implantation of a single piece IOL into an intact capsular bag(3), our case was unique in that the wound size (2.2 mm) was the smallest to be reported till date and there was no damage to the zonules, capsular bag, or IOL despite the single piece design of the latter

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Summary

INTRODUCTION

The advances in cataract surgery have made small, self-sealing clear corneal incisions (CCIs) a standard surgical technique. A study using cadaveric eyes showed that this type of incision was highly stable under substantial external pressure(1). We describe a patient with a history of uneventful cataract surgery using a small CCI who experienced isolated total aniridia, without damage to other intraocular structures after blunt trauma to the eye

CASE REPORT
DISCUSSION
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