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A 72 year-old male patient suffered from eyeball rupture on his left eye during an accident about six years ago. He was sent to a nearby medical center and diagnosed with corneal perforation, traumatic cataract, and hyphema. He was immediately treated with surgical intervention including primary repair of cornea, anterior vitrectomy and cataract extraction but the intraocular lens was not implanted concomitantly.
Six years later, the patient came to our clinic for consultation. The uncorrected visual acuity were 20/100 and 20/2000 on the right and left eyes respectively. With a subjective refraction of -1.00 -2.5 x 95 OD and +12.00 -0.75 x 100 OS, the best-corrected visual acuity were 20/50 on the right and 20/100 on the left side respectively. For the left eye, slit lamp biomicroscopy showed a whitish scar about 1 mm away from the center of cornea nasally (Figure 1). The anterior chamber depth was not shallow but the pupil was irregular shaped and mid-dilated. There was a posterior synechia between the iris and the residual lens capsule around the nasal part of the pupil but no implantation of intraocular lens was noted (Figure 2). The corneal topography was shown in Figure 3.
As the result, the blurry vision experienced by the patient was due to aphakia, corneal scar and irregular astigmatism but the patient refused to have an secondary implantation of intraocular lens on his left eye for personal reason. Actually, the vision would not be good after the implantation intraocular lens because of corneal scar and irregular astigmatism. Therefore, RPG lens fitting may be a good option to this case. Then, the limbal RGP lenses was prescribed (Figure 4) that giving the patient a vision of 0.6.
Figure 1. There was a whitish scar on cornea of the left eye being 1mm away from the center nasally.
Figure 2. There was a posterior synechiae between the iris and the residual lens capsule around the nasal part of the pupil but no implantation of intraocular lens was noted.
Figure 3. The corneal topography of the traumatized eye showed topographical steepening over the corneal scar.
Figure 4. The traumatized eye was fitted with an limbal RGP contact lens.