Primary posterior chamber intraocular lens implantation in traumatic cataract with posterior capsule breaks

In patients with incomplete posterior capsule support, posterior chamber intraocular lenses (PC-IOLs) were implanted with both haptics transscleral fixation. This causes more damage to the eye and may result in more complications. In patients with small posterior breaks, non-fixation or single haptic fixation may be adequate.

Thirty-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retrospected. Posterior chamber intraocular lenses were implanted in all these patients with three techniques, ie, without fixation, with single haptic fixation and with both haptics fixation. The selection of the technique was based on the position and size of the posterior capsule. The follow-up period was 21 days to 28 months (mean, 15.2 months).

Intra-operative problems included ciliary body bleeding (two patients, 6.25%) and enlargement of posterior capsule breaks (2 patients, 6.25%). Postoperative visual acuity was 0.5 or better (corrected) in 28 case (87.5%) and 0.1-0.4 in four patients (12.5%). Postoperative complications included hyphema (6 eyes, 18.8%), transient intraocular pressure elevation (6 eyes, 18.8%), transient hypotention (7 eyes, 21.8%). Postoperative IOL position were good except one case of IOL tilt. No pupillary capture or endophthalmitis was found.

Not all PC-IOLs have to be fixed by two haptics. In patients with small posterior capsule breaks, PC-IOL may not be fixed or fixed by only one haptics.