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Scheimpflug imaging of pediatric posterior capsule rupture.

Grewal DS, Jain R, Brar GS, Grewal SP - Indian J Ophthalmol (2009 May-Jun)

Bottom Line: Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) confirmed the traumatic cataract in the region of the PCT visualized as increased lens density at the cortex-vitreous interface.Intra-operatively, the PCT was evident and phaco-emulsification with an IOL implant was performed.Postoperatively, his BCVA improved to 20/20 in the left eye with a well-centered in-the-bag IOL as found on slit-lamp and Scheimpflug images.

View Article: PubMed Central - PubMed

Affiliation: Grewal Eye Institute, Madhya Marg, Chandigarh - 160 009, India. dilraj@gmail.com

ABSTRACT
We report a case of an 11-year-old boy who presented two days after blunt trauma to the left eye with a slingshot. On examination his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp examination of the left eye revealed a Vossius ring, traumatic cataract, traumatic posterior capsule tear (PCT). The contour of the posterior capsule bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) confirmed the traumatic cataract in the region of the PCT visualized as increased lens density at the cortex-vitreous interface. The extent of the PCT in the greatest and least dimensions was documented before and after intraocular lens (IOL) implantation. Intra-operatively, the PCT was evident and phaco-emulsification with an IOL implant was performed. Postoperatively, his BCVA improved to 20/20 in the left eye with a well-centered in-the-bag IOL as found on slit-lamp and Scheimpflug images.

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Preoperative gonioscopy pictures showing a 360-degree angle recession
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Figure 0002: Preoperative gonioscopy pictures showing a 360-degree angle recession

Mentions: An 11-year-old boy presented two days following blunt trauma to his left eye caused due to a projectile released from a slingshot. On examination, his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp biomicroscopy of his left eye revealed a Vossius ring, traumatic cataract, traumatic PCT with a bulging-out of the lens cortex and a streak of blood at its lower edge [Fig. 1a]. Gonioscopy revealed a 360-degree angle recession [Fig. 2]. The injury was classified as closed globe injury, Type B, Grade 3, Zone 3, relative afferent pupillary defect (RAPD) negative according to the classification of the ocular trauma classification group.[2] The contour of the posterior bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) was performed and the images confirmed traumatic cataract in the region of PCT demonstrated as increased lens density at the cortex-vitreous interface [Fig. 1b and 1c]. The rotating Scheimpflug camera captured 50 image slices in a 360 degree circle which allowed the two dimensions of the tear to be visualized and measured. The extent of the PCT, in its least [Fig. 1b] and greatest dimensions [Fig. 1c] was documented using the linear measurement tool on Scheimpflug images prior to and following intraocular lens (IOL) implantation. The size of the posterior capsule opening was 5920 microns × 3880 microns before surgery. Intra-operatively the PCT was evident and hydro-dissection was not performed. Phaco-aspiration of the central core followed by cleaning of the cortex with the irrigation-aspiration hand-piece was carried out. The vitreous face was intact, condensed and did not prolapse into the capsular bag. The edges of the PCT were clearly visible as they were fibrosed, capsular bag fixation of the IOL could be achieved. Postoperative Scheimpflug images revealed a posterior capsule opening measuring 4840 microns × 3970 microns. His BCVA following IOL implantation improved to 20/20 in the left eye and the IOL was well-centered, in-the-bag as visualized on slit-lamp and Scheimpflug images [Fig. 3].


Scheimpflug imaging of pediatric posterior capsule rupture.

Grewal DS, Jain R, Brar GS, Grewal SP - Indian J Ophthalmol (2009 May-Jun)

Preoperative gonioscopy pictures showing a 360-degree angle recession
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683431&req=5

Figure 0002: Preoperative gonioscopy pictures showing a 360-degree angle recession
Mentions: An 11-year-old boy presented two days following blunt trauma to his left eye caused due to a projectile released from a slingshot. On examination, his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp biomicroscopy of his left eye revealed a Vossius ring, traumatic cataract, traumatic PCT with a bulging-out of the lens cortex and a streak of blood at its lower edge [Fig. 1a]. Gonioscopy revealed a 360-degree angle recession [Fig. 2]. The injury was classified as closed globe injury, Type B, Grade 3, Zone 3, relative afferent pupillary defect (RAPD) negative according to the classification of the ocular trauma classification group.[2] The contour of the posterior bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) was performed and the images confirmed traumatic cataract in the region of PCT demonstrated as increased lens density at the cortex-vitreous interface [Fig. 1b and 1c]. The rotating Scheimpflug camera captured 50 image slices in a 360 degree circle which allowed the two dimensions of the tear to be visualized and measured. The extent of the PCT, in its least [Fig. 1b] and greatest dimensions [Fig. 1c] was documented using the linear measurement tool on Scheimpflug images prior to and following intraocular lens (IOL) implantation. The size of the posterior capsule opening was 5920 microns × 3880 microns before surgery. Intra-operatively the PCT was evident and hydro-dissection was not performed. Phaco-aspiration of the central core followed by cleaning of the cortex with the irrigation-aspiration hand-piece was carried out. The vitreous face was intact, condensed and did not prolapse into the capsular bag. The edges of the PCT were clearly visible as they were fibrosed, capsular bag fixation of the IOL could be achieved. Postoperative Scheimpflug images revealed a posterior capsule opening measuring 4840 microns × 3970 microns. His BCVA following IOL implantation improved to 20/20 in the left eye and the IOL was well-centered, in-the-bag as visualized on slit-lamp and Scheimpflug images [Fig. 3].

Bottom Line: Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) confirmed the traumatic cataract in the region of the PCT visualized as increased lens density at the cortex-vitreous interface.Intra-operatively, the PCT was evident and phaco-emulsification with an IOL implant was performed.Postoperatively, his BCVA improved to 20/20 in the left eye with a well-centered in-the-bag IOL as found on slit-lamp and Scheimpflug images.

View Article: PubMed Central - PubMed

Affiliation: Grewal Eye Institute, Madhya Marg, Chandigarh - 160 009, India. dilraj@gmail.com

ABSTRACT
We report a case of an 11-year-old boy who presented two days after blunt trauma to the left eye with a slingshot. On examination his best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp examination of the left eye revealed a Vossius ring, traumatic cataract, traumatic posterior capsule tear (PCT). The contour of the posterior capsule bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany) confirmed the traumatic cataract in the region of the PCT visualized as increased lens density at the cortex-vitreous interface. The extent of the PCT in the greatest and least dimensions was documented before and after intraocular lens (IOL) implantation. Intra-operatively, the PCT was evident and phaco-emulsification with an IOL implant was performed. Postoperatively, his BCVA improved to 20/20 in the left eye with a well-centered in-the-bag IOL as found on slit-lamp and Scheimpflug images.

Show MeSH
Related in: MedlinePlus