February 27, 2019
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VIDEO: Traumatic cataract with pinhole pupilloplasty

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Traumatic ocular injuries are often debilitating and visually challenging. These injuries require utmost care and attention as they can have repercussions that can last for a lifetime. A thorough preoperative evaluation is often hindered due to either rupture of the globe or accompanied haziness of the media that prevents detailed intraocular evaluation.

The video shows a case of traumatic injury with corneal tear and prolapse of lenticular material in the anterior chamber with associated posterior capsular rupture. The case is handled by performing anterior vitrectomy with glue-assisted intrascleral haptic fixation. Due to associated corneal opacity, a pinhole pupilloplasty procedure is performed that helps to focus the central rays and limit the entry of rays emerging from the peripherally aberrated cornea. The pinhole pupil effect helps to focus and impart good visual and image quality to patients in the immediate postoperative period. The surgical procedure to tackle the corneal opacity, if needed, can be planned at a later stage after the inflammation subsides.