When you look at this post-op slit-lamp microscope photo, you may initially think that it looks less than ideal. But you may not realize that this patient is seeing 20/40 on post-op day 1 and this is a great result and recover from a prior severe trauma. This patient sustained a ruptured globe injury where a metallic foreign body went through the iris, the lens, and ended up in the retina. The patient had a ruptured globe repair, lensectomy, and vitrectomy with removal of the foreign body. He was left aphakic during the healing period and now returns to our resident clinic for secondary IOL placement and pupilloplasty to repair the chronic sectoral mydriasis. The resident does an excellent job of pupilloplasty and AC IOL placement. Other IOL options were also considered, including scleral fixated IOLs such as with gore-tex sutures or the Yamane technique. The outcome is excellent and the patient is quite pleased since he never anticipated returning to good visual function after the severe trauma.
click to learn from this case of ACIOL placement and pupilloplasty after trauma: