Sutured posterior chamber intraocular lenses for traumatic cataract in Africa

Ocular trauma is common in low-income countries. Groote Schuur Hospital manages large numbers of patients with the manifestations of ocular trauma every year. The lens and its supporting structures, major refractive components of the eye, may be damaged in more than half of cases of severe trauma. Despite this, there is still some doubt as which is the best modality for the most successful rehabilitation of patients who have such severe lens damage as to necessitate its removal along with the capsule in which it is contained. lntraocular lenses sutured to the sclera in the posterior chamber of the eye (SL TC - Sutured lenses for traumatic cataract) - in the natural position of the crystalline lens - is standard practice at Groote Schuur Hospital in selected patients. It is a difficult and intricate procedure, usually only performed by consultants experienced in the technique. The majority of patients who undergo ocular trauma are young, necessitating rapid and effective optical rehabilitation to maximise productivity and quality of life. The use of contact lenses in aphakic, previously traumatised eyes may be the least invasive modality but is not appropriate in all cases. Anterior chamber lenses, especially the older versions with closed loop haptics, have been associated with numerous complications despite being significantly easier to implant'. Numerous other options such as Iris claw fixated lenses, intraocular lenses sutured to the Iris and tissue techniques for the fixation of posterior chamber intraocular lenses have not been used to date at Groote Schuur Hospitar4. Habit and anecdote regarding the dangers of anterior chamber intraocular lenses in patients with presumed co-existing angle trauma has precluded the use of these anterior chamber lenses in patients known to have had trauma. A marker for such trauma, angle recession, may be found in up to 15% of patients in certain parts of the drainage area of our hospital. The selection of patients for SL TC has not been standardized and there may be some difficulty in prognosticating visual outcome in these patients without large series that pertain directly to those eyes that have sustained trauma

Grantor

Division of Ophthalmology

Year dc:date.issued

2013

Author dc:creator

• Rogers, Graeme J

Advisor dc:contributor.advisor

• Cook, Colin D

• ophthalmology

Handle dc:identifier.uri

http://hdl.handle.net/11427/36645

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/36645