This young patient sustained a ruptured globe injury with a large central corneal laceration and puncture of the crystalline lens. The original repair surgery was performed by removing the crystalline lens, implanting an IOL, and suturing the cornea back together. Now, many months later, there are further challenges with the IOL dislocated and the patient not seeing much. Our guest surgeon is Dr Amar Agarwal who performs two procedures which has has innovated: the glued IOL technique for scleral fixation and then a pinhole pupilloplasty to improve the vision substantially despite the corneal scar.
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One day in the future perhaps, we will be able to replace such scarred corneas with transplants of clear, non aberrated corneas and avoid having to make the pupil a pinhole opening that restricts light and inhibits the ability to diagnose and treat the retina. One can dream right?