Overcoming the Dual Challenge: Successful Visual Rescue in Traumatic Cataract with Adherent Leucoma

Abstract: Background: Traumatic cataract with adherent leucoma is among the most complex combined anterior segment injuries, typically managed with staged surgery or primary keratoplasty, which carries risks of graft rejection, steroid dependency, and delayed rehabilitation. Non-keratoplasty reconstruction of this combination remains rare, reported only in isolated cases. Case Description: Penetrating trauma in a 48-year-old man with hand-movement vision, adherent leucoma with iris incarceration, an inferiorly distorted pupil, dense mature cataract, and a shallow, asymmetrical anterior chamber. Management: Instead of primary keratoplasty, four interdependent steps were combined in a single procedure while sparing the stable, non-central scar: synechiolysis, iris-hook stabilisation, capsular-tension-ring-supported small-incision cataract surgery, and in-the-bag IOL implantation with McCannel pupilloplasty. Outcome: At day 7, the BCVA had increased to hand movements, at 1 month to 6/12, and remained stable at 6/12 at 3 months, without any recurrent synechiae or complications. Conclusion: In selecting patients, particularly where resources and donor tissue are limited, this case demonstrates a cornea-sparing alternative to staged or keratoplasty-based management. Keywords: Traumatic cataract, adherent leucoma, cataract surgery, staged surgery. Title: Overcoming the Dual Challenge: Successful Visual Rescue in Traumatic Cataract with Adherent Leucoma Author: Dr. Devesh Yadav, Dr. Arvind Ram, Dr. Avirupa K. Banik, Dr. Gunjan Sharma International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 14, Issue 1, April 2026 - September 2026 Page No: 583-587 Research Publish Journals Website: www.researchpublish.com Published Date: 04-September-2026 DOI: https://doi.org/10.5281/zenodo.22300934 Paper Download Link (Source) https://www.researchpublish.com/papers/overcoming-the-dual-challenge-successful-visual-rescue-in-traumatic-cataract-with-adherent-leucoma