Aniridia after blunt trauma and presumed wound dehiscence in a pseudophakic eye

ABSTRACT This was a report about a pseudophakic patient who experienced isolated total aniridia without damage to other intraocular structures following blunt trauma to the eye. This patient had a history of uneventful cataract surgery using a small clear corneal incision (CCI). This 71-year-old male presented at our clinic with glare in his left eye. He reported that he had fallen down while drunk and struck his left eye against a stone on the road 15 days earlier. He had undergone cataract surgery on his left eye nine months before the accident at another eye clinic. Slit-lamp examination showed total aniridia in his left eye, but there was no hyphema or cells in the anterior chamber. The intraocular lens in his left eye was stable, without decentration, dislocation, or zonular dehiscence and remained in an intact capsular bag. Review of the medical records from the surgical clinic at which he had undergone cataract surgery indicated no specific findings for any intraocular structure including the iris. He had previously undergone an uneventful phacoemulsification for his left eye through a 2.2 mm CCI, followed by the implantation of a single piece acrylic intraocular lens inside an intact capsular bag. This report showed that small-sized CCIs can be opened postoperatively by trauma and that this can result in isolated total aniridia without damage to other intraocular structures.摘要（ABSTRACT）：本报告为1例人工晶状体眼患者的病例报道，该患者在眼部钝挫伤后出现孤立性全虹膜缺失（isolated total aniridia），且未累及其他眼内组织结构（intraocular structures）。患者既往接受过顺利的透明角膜微小切口（small clear corneal incision, CCI）白内障手术。该71岁男性因左眼眩光前往我院门诊就诊，自述15天前醉酒后摔倒，左眼撞击路面石块。患者于外伤前9个月于另一眼科诊所接受左眼白内障手术。裂隙灯检查显示左眼全虹膜缺失，但前房（anterior chamber）无积血（hyphema）或炎性细胞。患者左眼的人工晶状体（intraocular lens, IOL）位置稳定，无偏心（decentration）、脱位（dislocation）或悬韧带断裂（zonular dehiscence），且仍处于完整的晶状体囊袋（capsular bag）内。查阅其接受白内障手术的外科诊所的病历记录，结果显示包括虹膜在内的所有眼内组织结构均未见异常。患者此前通过2.2 mm透明角膜微小切口完成左眼超声乳化白内障吸除术（phacoemulsification），随后将一片式丙烯酸酯人工晶状体植入完整囊袋内。本病例表明，术后创伤可导致微小透明角膜切口裂开，进而引发孤立性全虹膜缺失，且未累及其他眼内组织结构。