Subconjunctival Dislocation Research Articles

Traumatic pseudophacocele: A case report with review of literature

A elderly male presented with painful loss of vision in the left eye for 20 days with expulsion of intra-ocular content following a blunt trauma. The best corrected visual acuity was counting fingers close to face (CF-CF). Slit lamp examination revealed ciliary tissue prolapse with gaping of incision scar along with a posterior synechia, iris pigments, vitreous in Anterior chamber, cells and flare. Patients presented aphakic and had the extruded rigid PMMA IOL with a broken haptic with him. Fundoscopic examination and B scan imaging were suggestive of vitreous haemorrhage. Pseudophacocele happens following blunt trauma leading to dehiscence of the corneo-scleral wound scar. Subconjunctival dislocation is the most common type, however sub-choroidal dislocation has also been seen. Our case is an extreme one where the IOL is completely extruded from the eye.An early diagnosis can help prevent serious infective complications and have good visual outcomes.

Traumatic Phacocele: A case report

Most cases of phacocele are secondary to a blunt trauma, associated with a risk factor like advanced age, surgery, or systemic diseas affecting scleral rigidity. We report the case of a 76-year-old patient admitted for a subconjunctival dislocation of the crystalline lens after a blunt trauma, without other associated ocular lesions, managed with extraction of the crystalline and a secondary implantation, with an amelioration of the visual acuity.

Traumatic lenticele – A rare case report

Traumatic subconjunctival dislocation of the lens (phacocele or lenticele) is of relatively rare occurrence. We report an unusual case of subconjunctival dislocation of the cataractous lens following blunt ocular trauma by cow horn in an elderly patient without having any previous ocular surgery or trauma. Blunt trauma resulted in indirect scleral rupture with subsequent dislocation of the crystalline lens in the subconjunctival space. The pathophysiological mechanism, clinical presentation, and management are discussed in this case report.

Traumatic pseudophacocele

A 70-year-old man presented with blunt trauma to his pseudophacic eye, resulting in subconjunctival dislocation of the posterior chamber intra-ocular lens. This rare incidence of traumatic pseudophacocele, occurring 5 years after cataract surgery and how its management salvaged useful vision is reported here.

Superior subconjunctival dislocation of intraocular lens following blunt trauma: A rare case report

Subconjunctival dislocation of the intraocular lens secondary to trauma is an unusual and serious condition in the pseudophakic eye. Here, a case of 75 years old male who had traumatic superior subconjunctival dislocation of intraocular lens to his right eye with cow’s horn is reported. The patient was managed with surgical extraction of the lens and planned for secondary intraocular lens implantation. It is quite challenging to manage such a case. Despite, proper surgical management visual outcomes are always guarded in such patients with blunt trauma.

Phacocele presenting as localized hematoma in a suspected case of traumatic occult scleral rupture

Trauma can result in subconjunctival dislocation of lens, which is a rare event. Here, we report a case of phacocele, which masqueraded as localized hematoma in a case of traumatic occult scleral rupture.

Traumatic Subconjunctival Dislocation of Fractured Posterior Chamber Intraocular Lens by Cow Horn Injury

Traumatic sub-conjunctival dislocation of posterior chamber intraocular lens is a rare and emergency condition. This communication is to report a rare ocular trauma by cow horn. A 52 year old male farmer presented with history of cow horn injury to his right eye. He had pain redness and decreased vision in his right eye. His posterior chamber IOL which was implanted two years back,was found dislocated to superiotemporal sub-conjunctival space with one broken haptic in anterior chamber and was removed surgically. Such a dislocation has not yet been reported in Indan literature and rarely reported in international literature to the best of our knowledge.

Sub-conjunctival dislocation of posterior chamber intra-ocular lens: five years after manual, small-incision cataract surgery.

Ocular trauma can cause serious complications in eyes operated for cataract. A 70-year- old lady had sustained blunt trauma to the left lower lid which resulted in a sub-conjunctival dislocation of the posterior chamber intraocular lens (PCIOL). The patient had undergone an uneventful manual, small-incision, sutureless cataract surgery with implantation of a PCIOL for senile cataract five years ago in the same eye. She had no ocular or systemic predisposing factors for wound dehiscence. Surgical exploration revealed a scleral rupture 7 mm in length, 2 mm behind the limbus at the 12'O clock position along the surgically-constructed wound. However, the scleral tunnel was not damaged. The PCIOL was removed. Wound closure was done to avoid infection of the intraocular structures. Her best-corrected visual acuity was 20/60 at the three months' follow-up. Surgeons should be aware of such complications occurring due to trauma. We recommend suturing of the scleral wound to strengthen it in cases of a deep scleral groove or when there is a possibility of a premature entry of the wound into the anterior chamber.

Subconjunctival lens dislocation

In their article on patients with subconjunctival crystalline lens dislocation secondary to blunt ocular trauma,1 Yurdakul and coauthors observed that all patients reported to have subconjunctival lens dislocation to date, including theirs, were older than 40 years and attributed this to the presence of a hard lens and rigid sclera as apparent prerequisites for the subconjunctival dislocation. We reported a case of posttraumatic subconjunctival dislocation of the lens and its successful management in a 16-year-old patient.2 The patient had Ehlers-Danlos syndrome type VI, and the defective collagen synthesis and susceptibility to trauma in this condition seem to be the reason for the young age at presentation. Other differences between our case and other reported cases were the unusual inferonasal subconjunctival dislocation of the lens and the long period (90 days) that the dislocated lens remained intact subconjunctivally without being absorbed. Previously, the longest duration was 2 months.3 We believe the underlying connective tissue disorder and the young age of the patient explain the findings. Yurdakul and coauthors rightly conclude that with timely intervention, the visual outcome is reasonably good. Amit Gaur MD, FRCS Yog Raj Sharma MD Rejiv Sudan MD aSheffield, United Kingdom bNew Delhi, India

Management of Scleral Defect With Phacocele

Subconjunctival dislocation of the crystalline lens is known as phacocele. Most cases of phacocele are associated with blunt trauma, existence of scleral rigidity, hard crystalline lens, and a history of scleral surgery. We report a case of traumatic phacocele with a scleral defect in a patient whom had been operated for trabeculectomy 5 years ago.

Traumatic subconjunctival crystalline lens dislocation

Purpose: To evaluate the clinical features and visual outcomes in patients with traumatic subconjunctival crystalline lens dislocation. Setting: Izmir Atatürk Education and Research Hospital, Department of Ophthalmology, Izmir, Turkey. Methods: The clinical records of 5 patients with subconjunctival crystalline lens dislocation secondary to blunt trauma were reviewed. Results: The median age of 3 women and 2 men was 63 years (range 62 to 73 years). The lenses were dislocated to the superior (n = 1), temporal (n = 1), superotemporal (n = 1), and superonasal (n = 2) quadrants. All patients had various degrees of hyphema and vitreous hemorrhage. One patient had traumatic optic neuropathy. Visual acuity improved in all patients after lens removal and scleral rupture repair. Conclusion: With timely intervention, the visual outcome was reasonably good in patients with subconjunctival dislocation of the crystalline lens.

Subconjunctival Dislocation of an Anterior Chamber Intraocular Lens

Post-traumatic dislocation of an intraocular lens (IOL) is a serious complication, especially after a blunt trauma because the posterior chamber lenses can potentially dislocate subconjunctively. We report a case of subconjunctival dislocation of a Kelman multiflex AC IOL. Such cases require immediate wound repair with IOL explantation to prevent endophthalmitis.

Traumatic phacocele

We report a case of traumatic phacocele in a 42-year-old patient with a history of congenital glaucoma and bilateral goniotomies as an infant. Her left eye had little vision and poorly controlled intraocular pressure but was comfortable until her presentation after blunt trauma. Phacocele or subconjunctival dislocation of the crystalline lens is a rare consequence of blunt trauma, particularly in a patient whose only previous ocular surgery was goniotomy more than 40 years ago.

Traumatic Subconjunctival Dislocation of the Crystalline Lens and Its Surgical Management

The authors report a case of a 40-year-old female who had sustained a blunt ocular trauma resulting in anterior scleral rupture and subconjunctival dislocation of the crystalline lens. Anterior segment ultrasound aided in the diagnosis. Surgical exploration revealed a 6 mm long anterior scleral rupture which was repaired. Postoperatively the patient had a best corrected visual acuity of 6/18.