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BLOG: Traumatic pseudophacocele
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Extrusion of an IOL into the subconjunctival space has been termed “pseudophacocele.” Blunt trauma is the major factor behind the forceful expulsion of the IOL into the subconjunctival space. Forceful extrusion of the IOL has been reported in the suprachoroidal space, in the vitreous cavity and sometimes outside the eyeball.
A pseudophacocele can be detected with slit lamp examination but occasionally the view is hampered by the presence of subconjunctival hemorrhage and hyphema. Management of pseudophacocele depends on the associated traumatic injuries to the eye apart from IOL extrusion, often requiring a multidisciplinary approach and the help of a vitreoretinal surgeon.
The surgical video demonstrates a case of pseudophacocele. Infusion is introduced into the eye with the help of a trocar anterior chamber maintainer (Mastel). Conjunctival peritomy is performed and the extruded IOL is removed, followed by suturing of the scleral wound. Three-port pars plana vitrectomy is performed; hyphema and vitreous hemorrhage are cleared and followed by a glued IOL procedure. Pupilloplasty is performed to recreate the pupil shape with a modified Siepser’s slipknot technique.