2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 12: Preparing for Cataract Surgery in Special Situations
Ocular Trauma
Cataract in an Eye With Damage to Other Ocular Tissues
Iris trauma commonly coexists with traumatic cataract (Fig 12-12). Sphincter ruptures result in irregular pupil size and shape. The surgeon can repair iridodialysis at the time of cataract removal by suturing the iris root to the scleral spur. Though not apparent on slitlamp examination, corneal endothelial damage can be significant and may not manifest until after surgery, when severe corneal edema occurs. Preoperative specular microscopy can be helpful in determining the status of the corneal endothelium and its ability to withstand cataract surgery. Trauma sufficient to cause iris tears and cataract warrants careful inspection for zonular damage and insult to the posterior segment. If a retinal detachment is present, cataract removal may be necessary to allow adequate visualization for subsequent surgical repair.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.