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[Wound rupture 1 year after cataract operation with 7 mm scleral tunnel incision (no-stitch technique)]
D T Pham1, N Anders, J Wollensak
1Augenklinik im Virchow-Klinikum der Humboldt-Universität zu Berlin.
Background:
Wound strength of the self-sealing tunnel technique is much higher than the former sutured corneoscleral incision, as many experimental investigations have shown. Therefore only a few cases of traumatic wound rupture after tunnel incision are published. We report on a traumatic wound rupture with loss of the IOL with capsular bag and iris.
Case Report:
An 80-year-old patient suffered a traumatic wound rupture one year after cataract surgery with a 7-mm scleral self-sealing wound construction. The IOL with capsular bag and iris were expulsed and the wound construction was damaged. By gonioscopy a large irregular lesion of the inner lamella could be observed. After pars plana vitrectomy of the severe vitreous hemorrhage a visual acuity of 0.5 was achieved. The mechanism of the wound rupture is discussed.
Conclusion:
The loss of the iris and the IOL and the lesion of the inner lamella suggest a massive force. The yet existing relative wound stability after the trauma depends on the still working self-sealing mechanism of the tunnel construction in spite of the lesion of the inner lamella.