The efficacy of various surgical procedures for the treatment of traumatic subluxation of lens

Abstract

Objective To observe the efficacy of various surgical procedures for the treatment of traumatic subluxation of lens. Methods Sixty eyes of 60 cases with traumatic cataract combined with subluxation of lens were retrospectively analysed. Based on the different degree of the dislocation of the lens, the patients were divided into four groups, each group contained 15 eyes of 15 cases. Group A, the range of broken suspensory ligament was <90°, underwent phacoemulsification and implantation of the C loop IOL .Group B, the range was 90°-<180°, underwent phacoemulsification combined with implantation of IOL and capsular tension ring.Group C, the range was 180°-<270°, underwent capsular tension ring suture in the ciliary sulcus. Group D, the range was ≥270°, received the three channels closed lens ectomy and anterior segment vilmectomy and IOL implantation with the ciliary suture fixation. At 1 week, 1, 3 and 6 months after operation the anterior chamber inflammation, location of IOL, the best corrected visual acuity (BCVA), intraocular pressure and other complications were observed. Results One week after operation, in Group A, aqueous flare was (-), position of IOL was centered. BCVA ≥0.5 were in 11 eyes(73.3%); in Group B and Group C, aqueous flare was (+ ), position of IOL was centered, BCVA ≥0.5 were in 9 eyes(60.0%). In Group D, aqueous flare was (+ ), IOL was slightly offset position in 3 eyes, BCVA ≥0.5 were in 4 eyes(26.7%). One month after operation, four groups of patients with anterior chamber inflammation reaction had subsided. In Group A, BCVA ≥0.5 were in 13 eyes (86.7%); in Group B and Group C, BCVA ≥0.5 were in 12 eyes (80.0%) in each group; in Group D, BCVA ≥0.5 were in 8 eyes(53.3%). After 3 and 6 months after surgery, four groups of BCVA were stable, position of IOL centered and macular edema, detachment of cyclodialysis and choroidal detachment serious complication. Conclusion According to the degree of lens subluxation, a reasonable choice of correct operation can significantly improve the postoperative visual acuity and reduce the intraoperative and postoperative complications. Key words: Ocular trauma; Subluxation of lens, traumatic; Capsular tension ring; Surgical procedures; Efficacy