Retinal break associated with traumatic lens dislocation or subluxation requiring vitrectomy

Graefes Arch Clin Exp Ophthalmol. 2020 Mar;258(3):693-697. doi: 10.1007/s00417-019-04530-9. Epub 2019 Nov 28.

Abstract

Background: Both ectopia lentis and retinal injury are common results of blunt ocular trauma. Here, we investigated the incidence and characteristics of retinal breaks associated with ectopia lentis caused by blunt ocular trauma.

Methods: Patients who underwent pars plana vitrectomy to treat traumatic lens subluxation and dislocation were retrospectively reviewed. The incidence, characteristics, and outcomes of retinal breaks were analyzed.

Results: Forty-five eyes from 45 patients were included in the study. Seventeen eyes (37.7%) were complicated by retinal breaks or detachment, but only four (8.9%) were identified pre-operation. Our study revealed that retinal breaks were more frequently located at the superior (72.7%) and peripheral (81.8%) retina. All patients achieved anatomic recovery post-surgery. The eyes with and without retinal breaks did not differ significantly with respect to initial or final visual acuity. The final visual outcomes were independently and significantly associated with visual acuity at presentation (P = 0.001).

Conclusions: Retinal breaks occurred in approximately one-third of patients with traumatic ectopia lentis and were difficult to observe pre-operation. Complete ophthalmic evaluation and timely intervention may help achieve favorable outcomes.

Keywords: Lens dislocation; Lens subluxation; Retinal break; Trauma; Vitrectomy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Eye Injuries / complications*
  • Eye Injuries / diagnosis
  • Eye Injuries / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Subluxation / diagnosis
  • Lens Subluxation / etiology
  • Lens Subluxation / surgery*
  • Lens, Crystalline / surgery*
  • Male
  • Middle Aged
  • Retinal Perforations / diagnosis
  • Retinal Perforations / etiology
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Visual Acuity*
  • Vitrectomy / methods*
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / surgery
  • Young Adult