Pupillary capture of implantable contact lens after blunt trauma
A 33-year-old woman visited our clinic with blurry vision and periorbital swelling after experiencing blunt trauma to left eye. Ten months earlier, she had implantable contact lens (ICL) implantation in the left eye. Biomicroscopic examination showed that that 1 footplate of the ICL was entrapped in the pupillary aperture at the 7 o'clock position and the ICL was placed vertically. The patient had limited ocular movement in lateral gaze, and the computed tomography showed a medial orbital wall fracture. Pupillary capture of the ICL was surgically corrected with an iris manipulator under topical anesthesia. After the ICL was repositioned, the patient's uncorrected visual acuity was restored to 20/32, as before the injury. Pupillary capture of the ICL may occur after blunt ocular trauma.
Available from: Shail A Vasavada
- "One case report even describes a case in which ICLs were stable after a grenade explosion . Subsequently, there have been five cases of ICL dislocation reported in the literature [7-11], three of which were caused by blunt ocular trauma, similar to ours (Table 1)[7, 10, 11]. "
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ABSTRACT: Purpose :
Present a case of dislocation of an Implantable Collamer Lens (ICL) that occurs after blunt trauma and review the published literature on this topic.
Case report and literature review using PubMed.
A 44 year-old male presented to the emergency department with sudden onset of blurry vision after blunt trauma to the left eye. Three years prior, he had undergone bilateral ICL placement for high myopia. On examination, the superotemporal haptic was noted to be dislocated into the anterior chamber, but there was no endothelial touch by the dislocated lens. The patient had an associated hyphema that was medically managed, and 2 weeks after the injury, the patient underwent ICL repositioning. A review of the literature was performed and five previous cases of ICL dislocation were identified. Three of these occurred after blunt trauma. One of these cases was associated with endothelial touch and decompensation and eventually required a descement’s stripping endothelial keratoplasty (DSAEK).
Dislocation of ICLs after blunt trauma is a rare but important potential sequela of the procedure and can lead to corneal decompensation if there is lens-endothelial touch. All patients who suffer blunt dislocation of ICL should be followed long-term after repositioning for signs of endothelial loss and dysfunction.
The Open Ophthalmology Journal 05/2014; 8(1):24-6. DOI:10.2174/1874364101408010024
Available from: Antonio Leccisotti
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ABSTRACT: A 27-year-old woman had implantation of an angle-supported phakic intraocular lens (pIOL) for myopia in the left eye in 2003. Moderate iris atrophy and pupil ovalization were noted in 2005. In 2006, the eye was hit by a plastic bullet shot from a toy gun. The pupil became distorted as the inferior haptic engaged the pupil edge. Visual acuity was not affected. Surgical repositioning was uneventful, yielding a round pupil with no damage to the iris sphincter or the lens. The endothelium was not affected by the trauma or surgery. Previous iris atrophy may have facilitated pupillary capture because of reduced iris elasticity and pupil ovalization by the haptic. Blunt trauma can dislocate angle-supported pIOLs. Implantation of these IOLs should be discouraged in patients who perform activities that put them at risk for eye trauma.
Journal of Cataract and Refractive Surgery 01/2007; 32(12):2133-4. DOI:10.1016/j.jcrs.2006.05.037 · 2.72 Impact Factor
Canadian Journal of Ophthalmology 08/2009; 44(4):27-28. DOI:10.1139/i09-067 · 1.33 Impact Factor
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