Comparison of immersion ultrasonography, ultrasound biomicroscopy and anterior segment optical coherence tomography in the evaluation of traumatic phacoceles

Abstract

Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele). Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM) was compared to the anterior segment optical coherence tomography (AS-OCT) and B-scan ultrasonography (B-scan), in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.

Migrated subconjunctival crystalline lens: a traumatic phacocele

“…CT scan can be done for evaluation of orbital trauma, lens dislocation and orbital fractures. 5 The primary goal in the management of a phacocele is the extraction of the displaced lens and maintenance of globe integrity. 6 The wound should be meticulously explored; the crystalline lens should be separated from the underlying vitreous and the scleral wound should be repaired with or without an intraocular lens (IOL) implantation.…”