Traumatic injuries often leave a devastating effect on the visual potential of patients for an entire lifetime. Tactful handling of these cases is necessary, and often multiple surgical approaches are necessary to optimize the visual output.
This video showcases a case of traumatic injury with a cigarette lighter that burst into the patient’s eye, leading to corneal tear and cataract formation. The referring surgeon primarily addressed the case where the corneal tear repair was done followed by removal of the cataract.
There was massive iridodialysis that almost extended up to 180°, along with aphakia and a lot of cortical fluffy lens matter. Limited vitrectomy was initially performed in the mid-pupillary area, and an attempt was made to suture the iris to the scleral base with the help of 10-0 Prolene. The iris tissue cheese-wired, and iris suturing could not be performed. Hence, the disinserted iris tissue was removed with the vitrectomy probe and lens matter was cleared. A secondary IOL fixation with glued technique was performed, and the superior iris tissue was fixed to the scleral base beneath the flaps with 10-0 Prolene. The iris tissue present in the pupillary area was removed with the vitrectomy probe, and an effective pupillary zone was achieved for adequate visualization.
Postoperatively, the patient regained 20/40 vision with pinhole, and further interventions for the corneal involvement can be planned depending upon the patient’s requirements and various other considerations.