Case 5: Limbus to Limbus Corneal Laceration from Nail Gun Injury

Abstract

A 23-year-old-man presented with a large Zone I-II open globe injury of the left eye after a nail gun injury. The patient underwent repair of his corneal limbus to limbus laceration. During this time, the posterior lens capsule was noted to be violated with lens material and vitreous in the anterior chamber. Given the known posterior lens capsule violation, the lens was not taken primarily. The patient was then referred to retina and underwent a pars plana vitrectomy and lensectomy and was left aphakic. After three months of post-operative follow up, corneal suture removal was initiated. Suture removal was approached in a staged fashion over three visits spanning a month’s time. The patient was then referred to the contact lens service for evaluation six weeks after final suture removal and was fitted with a contact lens, resulting in best corrected vision of 20/25. Limbus to limbus lacerations require slow and staged suture removal to prevent wound leaks or complete dehiscence.