The surgical management
The present traumatic cataract case was treated in our department. The procedure implied the management of the loss of posterior capsule support with reverse optic capture. The cataract surgery was performed combined with 23G pars plana vitrectomy. A conventional 2.4 mm clear corneal incision was made along with paracentesis. A 360o intact continuous curvilinear capsulorhexis (CCC), smaller than usual—-with a diameter of about 4 mm—-was created by the use of capsulotomy forceps. Instead of a conventional cataract surgery, the hydrodelineation of the lens nucleus was performed without hydrodissection. The lens nucleus was extracted with low flow settings of a phacomachine. In order to remove the cortex, slow aspiration with manual coaxial handpiece was performed. When the majority of the cortex was removed, an extensive PCR was observed. It excluded the possibility of intraocular lens (IOL) implantation in the bag. To minimise the vitreous prolapse, an injection of dispersive viscoelastic was administered to create a tamponade near the torn part of the capsule. A single-piece foldable IOL was implanted and stable reverse rhexis fixation was obtained by applying a forward optic capture technique. After stabilising the anterior chamber and hydrating the corneal incisions, 23G pars plana vitrectomy was performed to evacuate herniated vitreous from the posterior capsule tear and dropping cortical fragments from the vitreous body. A standard postoperative medication, according to the praxis of the clinic, consists of topical dexamethasone and chloramphenicol. Consequently, it was prescribed and gradually tapered over the period of 4 weeks.