This patient had a traumatic injury to his eye 40 years ago and never sought the care of an ophthalmologist until recently when he felt that his vision was declining even more. A bungee cord (a strong elastic band with metal hooks) under tension snapped and hit him in the eye. Fortunately he did not sustain a ruptured globe, but there was damage to his anterior lens capsule and a dense sectoral cataract developed.
On slit-lamp examination during the pre-operative consultation, there was no evidence of phacodonesis or zonular loss. We planned for cataract surgery making sure to have extra supplies such as capsular hooks, capsular tension rings, capsular support segments, a variety of IOLs, and sutures.
Fortunately, during this case we did not encounter capsular weakness or zonular laxity/loss. There was no vitreous prolapse into the anterior chamber. The primary issue was avoiding the area of anterior capsule fibrosis.
To be on the safe side, we also made sure to bring the entire nucleus out of capsular bag just in case that a posterior capsule defect was present.
Click below to learn from these techniques to address a traumatic cataract: