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Methods of fixation of intraocular lenses according to the anatomical structures in trauma eyes
Author(s) -
Fiorentzis Miltiadis,
Viestenz Anja,
Heichel Jens,
Seitz Berthold,
Hammer Thomas,
Viestenz Arne
Publication year - 2018
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.22898
Subject(s) - medicine , sclera , ophthalmology , intraocular lens , subluxation , fixation (population genetics) , lens (geology) , hyphema , sulcus , eye injuries , surgery , glaucoma , poison control , pathology , population , alternative medicine , environmental health , petroleum engineering , engineering , injury prevention
Ocular trauma can lead to severe visual impairment and morbidity, depending on the anatomical structures affected. The main causes of ocular trauma include foreign bodies, impact by an object, falls, and chemicals. Most ocular traumas occur in children or young male adults. A meticulous slit lamp examination is crucial for assessing all anatomical structures. Trauma to the crystalline lens can result in dislocation, an intralenticular foreign body, cataract, fragmentation, and capsular breach. An intraocular lens (IOL) can endure subluxation or luxation under the conjunctiva, into the anterior chamber or the vitreous, or can be extruded. The surgical approach depends on the condition and morphology of the lens and the anatomical structures surrounding it. If there is capsular bag support, a secondary IOL can be placed in the sulcus using remnants of the damaged capsule. If there is no capsular bag support, a secondary IOL can be fixated to the anterior chamber angle, to the iris, or to the sclera. A detailed history of injury cannot always be obtained in trauma settings. Proper education, supervision, and certified safety eye protectors could prevent up to 90% of ocular injuries. Lens trauma can be treated with various surgical procedures and fixation techniques, which nevertheless require advanced surgical skills owing to the fine anatomical structure of the anterior segment. A careful surgical strategy should be established for a globe reconstruction after trauma with secondary lens implantation. Clin. Anat. 31:6–15, 2018. © 2017 Wiley Periodicals, Inc.