3068: CataractQuiz: Where is the crystalline lens?
Evaluating the presented surgical quiz and inset view confirms that severe blunt ocular trauma severed 360 degrees of zonular support, causing complete posterior dislocation of the crystalline lens into the vitreous cavity. The main view shows an aphakic anterior chamber with a wide, traumatic pupillary aperture, while the inset picture clearly reveals the clear, intact natural lens resting in the posterior segment on the retina. Managing a fully dislocated lens in a young patient requires a coordinated posterior segment approach involving pars plana vitrectomy, lensectomy, and secondary IOL fixation such as intrascleral haptic fixation once the natural lens is safely removed. Watch the video to see the surgical sequence for retrieving this posteriorly dislocated crystalline lens and reconstructing the anterior segment. What is your preferred technique for floating or fragmenting a clear dislocated lens in a young patient? Please comment your thoughts below.
