3108: corneal laceration ruptured globe
Managing an open globe injury with a corneal laceration, iris damage, and a ruptured lens capsule requires a structured, multi-step surgical protocol. Initial evaluation must always rule out an intraocular foreign body by obtaining a prompt CT scan before proceeding to the operating room. Once inside the operating suite, the primary goals are to meticulously suture the corneal laceration to restore globe integrity, assess the full extent of intraocular damage, and aspirate compromised cataract lens material. Deciding whether to insert an intraocular lens at the time of primary repair depends heavily on the nature of the trauma: clean cases with a very low risk of infection can safely receive a primary intraocular lens, whereas contaminated, dirty, or organic matter penetrations dictate leaving the eye aphakic to minimize endophthalmitis risk, allowing for a secondary intraocular lens placement during a future staged procedure. What would you do in this case? Comment below.
