Prager Alisa J, Basti Surendra
Department of Ophthalmology, Northwestern Feinberg School of Medicine, Chicago, IL, USA.
Am J Ophthalmol Case Rep. 2020 May 16;19:100742. doi: 10.1016/j.ajoc.2020.100742. eCollection 2020 Sep.
To describe the diagnosis and management of a patient with rupture of the posterior capsule (PC) following blunt trauma to the left eye.
68 year-old man presented with complaints of left eye pain, blurry vision and photophobia after getting hit in the left eye with a baseball. He was found to have a posterior capsule rupture, as well as mydriasis and zonular dialysis without formation of intumescent traumatic cataract. Femtosecond laser associated cataract surgery (FLACS) was performed to facilitate creation of an anterior capsulotomy and segmentation of the nucleus without additional strain on the posterior capsule, facilitating placement of a capsular tension ring segment and a 3-piece IOL in the sulcus. At three-month post-operative visit, his BCVA was 20/30 in the left eye with a well-centered IOL.
Isolated PC tear following high-speed blunt trauma is relatively rare and prior reports have managed these cases using standard phacoemulsification and IOL insertion. Our case highlights the advantages of using FLACS in management of traumatic PC tears and outlines modifications to this technique for such cases.
描述一名左眼钝挫伤后发生后囊破裂（PC）患者的诊断和治疗。
一名68岁男性在左眼被棒球击中后，出现左眼疼痛、视力模糊和畏光症状。检查发现其存在后囊破裂、瞳孔散大及悬韧带离断，但未形成肿胀性外伤性白内障。进行了飞秒激光辅助白内障手术（FLACS），以利于制作前囊切开并分割晶状体核，而不会给后囊增加额外张力，便于植入囊袋张力环片段和一枚3片式人工晶状体至睫状沟。术后3个月复诊时，其左眼最佳矫正视力（BCVA）为20/30，人工晶状体居中良好。
高速钝挫伤后孤立性后囊撕裂相对少见，既往报道采用标准超声乳化白内障吸除术和人工晶状体植入术治疗此类病例。我们的病例突出了使用FLACS治疗外伤性后囊撕裂的优势，并概述了针对此类病例该技术的改进方法。
