VIDEO: Scleral anchored lens after post-traumatic aphakia

In this video, Sébastien Guigou, MD, demonstrates a new implantation technique for the treatment of post-traumatic lens dislocation.

The patient was a 9-year-old child who presented with a severe globe injury from a dog bite. Examination revealed a large scleral wound of more than 1 cm, cataract, iridectomy and vitreous hemorrhage.

Initial management consisted of suturing the large scleral wound, pars plana phacophagy and exploration of the posterior segment with a 25-gauge vitrectomy system.

Examination of the retinal periphery showed retinal detachment at the ora serrata, which was treated with laser.

The second stage of management consisted of implantation of a scleral-fixated IOL – a Carlevale hydrophilic lens – and associated iridoplasty.

A Beaver blade was used to develop two scleral flaps 180° apart. The lens was inserted and the first haptic was retrieved using 25-gauge forceps. The anchor was positioned, without suture, under the 9 o’clock scleral flap.

The implant gently unfolded in the anterior chamber, and the second haptic was positioned in the same way using forceps, with the lens settling into a well-centered position.

Finally, the flaps and the conjunctiva were sutured.

Postoperative retroillumination shows the correct centration of the implant despite post-traumatic iridectomy. The hydrophilic haptics are well integrated.

The child recovered 16/20 vision.

For more information:

Sébastien Guigou, MD, can be reached at Centre Aix Vision, 44 ave Maréchal de Lattre de Tassigny, 13090 Aix-en-Provence, France; email: mgmretine@aixvision.fr.

Disclosure: Guigou reports no relevant financial disclosures.