Video Presentation

Facovitrectomy with iris prosthesis in complex ocular trauma with panuveitis

Video Details

First Author: M. A.Reyes Rodriguez SPAIN

Co Author(s):    H. Carreras Diaz   A. Garcia Garcia                          

Abstract Details



Purpose:

We present the video of the case of a 36-year-old woman with bilateral panuveitis due to Blau's syndrome, who suffered eye trauma in the right eye with perforating wound in lower limb and iris herniation.

Setting:

After emergency surgery, there is significant loss of visual acuity and photophobia. In the ophthalmological examination corneal astigmatism of 11 diopters in a 60 degree axis, inferior trauma aniridia, nuclear cataract and macular epiretinal membrane were observed.

Methods:

Scheduled surgery is performed 9 months after the trauma, and cataract phacoemulsification is performed with an 11-diopter toric monofocal intraocular lens implant on a 60-degree axis (model AT TORBI 709 M) and a brown colored sector iris (IPS®) prosthesis in the lower area above the intraocular lens, both endosacular. Vitrectomy is performed via three pathways 25 G via pars plana, posterior capsulotomy with vitreotome and peeling of the macular epiretinal membrane and inner limiting membrane stained with tripan blue (membrane dual®).

Results:

In the postoperative period we found a modification in the corneal astigmatism axis, which is why we proceed to rotate the intraocular lens with the aid of the intraoperative aberrometer (ORA System®) and the guided imaging system (VERION®). We did not find other complications at the anterior and posterior segment. Ocular inflammation has been controlled at all times with the use of oral corticosteroids and methotrexate.

Conclusions:

These cases of ocular trauma need to be addressed through multiple procedures to achieve the best possible outcome. The association with the presence of a previous panuveitis recommends minimally invasive surgery to generate the smallest possible inflammation. It is possible to obtain a satisfactory functional and refractive result as it happens in our patient.

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