Progressive hyperopic refractive changes after posterior capsule tear following blunt ocular trauma

Area of Science:

• Ophthalmology
• Traumatic eye injury
• Cataract surgery

Background:

• Blunt ocular trauma can lead to posterior capsule tears (PCT) and traumatic cataracts.
• Progressive hyperopia following isolated PCT is a rare long-term complication.
• Understanding the mechanism of hyperopic shift is crucial for effective management.

Observation:

• A 37-year-old female presented with delayed progressive hyperopia (+8.0 D) three years after blunt trauma to the right eye.
• The initial injury resulted in a posterior capsule tear (PCT) and traumatic cataract with emmetropia.
• Anterior segment OCT revealed lens fiber disorganization and liquefaction secondary to PCT.

Findings:

• Lens liquefaction and disorganization following PCT can cause significant, delayed hyperopic shifts.
• Femtosecond laser-assisted cataract surgery with a capsular tension ring segment and multifocal IOL successfully managed the hyperopia.
• Post-operative visual acuity of 20/20 was achieved with a well-centered IOL.

Implications:

• This case highlights a rare but significant long-term consequence of blunt ocular trauma.
• Advanced cataract surgery techniques are effective in managing progressive hyperopia after PCT.
• Further research into the long-term effects of ocular trauma on refractive error is warranted.