Traumatic subconjunctival migration of an intraocular lens, termed pseudophacocele, is a rare, but devastating complication following cataract surgery.[1,2,3,4] Herein, we describe a case of traumatic pseudophacocele following blunt ocular trauma.
A 65-year-old male patient visited our emergency outpatient department for severe loss of vision in the left eye (LE) following blunt ocular trauma. The best-corrected visual acuity (BCVA) in the LE was light perception and 20/20 in the right eye (RE). On examination, a rigid posterior-chamber intraocular lens (PCIOL) was seen in the superior subconjunctival perilimbal area associated with underlying evidence of scleral wound dehiscence [Fig. 1] and full-chambered hyphema precluding fundal view in the LE. B-Scan ultrasonography revealed vitreous hemorrhage with total retinal detachment. Two years before, he had undergone an uneventful small incision cataract surgery with implantation of PCIOL in his LE. Anterior-segment and posterior-segment examinations were unremarkable in the RE. At surgery, the patient underwent successful removal of subconjunctival PCIOL and pars plana vitrectomy for repair of retinal detachment with silicone oil tamponade. Traumatic aniridia and inferior retinal dialysis of 3'o clock hour were encountered in the course of surgery. About 4 months postoperatively, he underwent silicone oil removal in the LE. At the last controlled visit, he had BCVA of 20/200 in the LE.
Figure 1.
Colored anterior-segment image showing the posttraumatic migration of posterior-chamber intraocular lens in the superior subconjunctival space with underlying evidence of scleral wound dehiscence
Traumatic pseudophacocele associated with severe posterior-segment manifestation is a catastrophic complication of ocular trauma in a pseudophakic eye. It is an emergency situation where careful examination and proper treatment may help in the salvation of vision and the eyeball.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Mandal AK, Anand R. Traumatic pseudophacocele. Indian J Ophthalmol. 2003;51:177–8. [PubMed] [Google Scholar]
- 2.Bandyopadhyay R, Banerjee A, Bhaduri G, Singh M. Traumatic pseudophacocele. J Indian Med Assoc. 2004;102:731. [PubMed] [Google Scholar]
- 3.Bene C, Kranias G. Subconjunctival dislocation of a posterior chamber intraocular lens. Am J Ophthalmol. 1985;99:85–6. doi: 10.1016/s0002-9394(14)75875-1. [DOI] [PubMed] [Google Scholar]
- 4.Narang P, Agarwal A. Clinical outcomes in traumatic pseudophacocele: A rare clinical entity. Indian J Ophthalmol. 2017;65:1465–9. doi: 10.4103/ijo.IJO_1068_17. [DOI] [PMC free article] [PubMed] [Google Scholar]