Abstract
Purpose:Patients who have suffered an ocular trauma may present with varying degrees of injury to the anterior segment. In this retrospective interventional case series, we report the outcome of seven patients who underwent complete anterior segment reconstruction in a single surgery.Methods:All patients with posttraumatic corneal decompensation or scar, aphakia, and iris defect underwent human donor corneal graft transplantation and implantation of an intraocular lens combined with a flexible silicone iris prosthesis. Postoperative examinations included assessment of best corrected distance visual acuity, objective refraction, and intraocular pressure. Sensitivity to glare and subjective discontent with the eye’s appearance was rated on a scale from 1 to 10, with 1 standing for low and 10 for high severity.Results:Mean best corrected distance visual acuity (BCDVA) was 1.51 ± 0.26 logMAR preoperatively and 1.29 ± 0.36 logMAR postoperatively. Mean IOP was 15.71 ± 8.94 mmHg pre-surgery and 13.57 ± 6.52 mmHg post-surgery. The mean sensitivity to glare was reduced from 7.17 ± 2.91 to 3.80 ± 3.43 and subjective cosmetic disfigurement was reduced from 5.33 ± 3.35 to 1.80 ± 1.60.Conclusions:A single surgery technique for entire anterior segment reconstruction in trauma patients can effectively reduce glare and patient discontent with the eye’s appearance.
Highlights
Traumatized eyes often show multiple structural damages
Nowadays, there are implants which allow surgeons to reconstruct anterior ocular structures: human donor corneal grafts or corneal prostheses[2] can substitute the cornea, the human lens can be replaced with an intraocular lens, and the human iris can be substituted with an iris prosthesis.[3]
In which there is a complete reconstruction of the anterior segment – with corneal transplantation, implantation of an iris prosthesis, and implantation of an IOL – all performed in one single surgery
Summary
Almost the complete anterior segment of the eye is affected, including cornea, iris, and lens. In even more severe cases, the posterior segment of the eye is affected.[1] It is sometimes challenging to reconstruct these structures in one single surgery. Nowadays, there are implants which allow surgeons to reconstruct anterior ocular structures: human donor corneal grafts or corneal prostheses[2] can substitute the cornea, the human lens can be replaced with an intraocular lens, and the human iris can be substituted with an iris prosthesis.[3] We present our results in trauma cases. In which there is a complete reconstruction of the anterior segment – with corneal transplantation, implantation of an iris prosthesis, and implantation of an IOL – all performed in one single surgery
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