Vitreoretinal Management of Traumatic Dislocation of the Crystalline Lens

Purpose. To analyze the patients with secondary dislocation of CTR and IOL within 5 years from cataract surgery, to determine predisposing factors.Methods. 16 eyes of 15 patients aged66.2±6.7(from 49 to 82) with CTR/IOL complex dislocation within 5 years from cataract surgery were compared with 26 patients aged67.1±7.2(from 53 to 85), implanted with CTR during cataract surgery to manage zonule dehiscence and did not dislocate for at least 5 years, in respect of cause, axial length and IOL power, refraction, coexistent pathology, and trauma.Results. Axial length of the eyeball was23.8±1.3(from 21 to 29) in the group of patients with CTR/IOL dislocation and20.7±1.2(from 19 to 24) in patients with no dislocation present (p=0.008). Crystalline lens dislocation was diagnosed before surgery in 13 of 16 patients with CTR/IOL complex dislocation as opposed to 7 of 26 eyes in the control group (p=0.01). Pseudoexfoliation was present in 50% and 58% in both groups, respectively. Traumatic dislocation was present in 8 patients, none of them with CTR/IOL dislocation (p=0.04).Conclusion. Longer axial length may contribute to the failure of the CTR to prevent in-the-bag IOL dislocation. Traumatic dislocation appears to be well fixed with the CTR.

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Traumatic dislocation of crystalline lens with secondary glaucoma

Indian Journal of Ophthalmology - Case Reports ◽

10.4103/ijo.ijo_1_21 ◽

2021 ◽

Vol 1 (4) ◽

pp. 810

Author(s):

Sushma Tejwani ◽

Parin Mehta

Keyword(s):

Crystalline Lens ◽

Secondary Glaucoma ◽

Traumatic Dislocation

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Traumatic Dislocation of the Crystalline Lens

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000153751.67004.1c ◽

2005 ◽

Vol 58 (1) ◽

pp. 213-214 ◽

Cited By ~ 4

Author(s):

David A. Steinberg ◽

Cynthia L. Leslie

Keyword(s):

Crystalline Lens ◽

Traumatic Dislocation

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Management of traumatic dislocation of crystalline lens: Retropupillary iris-claw versus sutureless intrascleral-fixated intraocular lens

Taiwan Journal of Ophthalmology ◽

10.4103/tjo.tjo_48_20 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Karishma Goyal ◽

Nagendra Shekhawat ◽

Kamlesh Khilnani

Keyword(s):

Intraocular Lens ◽

Crystalline Lens ◽

Traumatic Dislocation ◽

Iris Claw

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Extrascleral Filling Using Endoillumination the First Experiencethe

Russian ophthalmology of children ◽

10.25276/2307-6658-2020-3-43-49 ◽

2020 ◽

pp. 43-49

Author(s):

V.Y. Markevich ◽

◽

T.A. Imshenetskaya ◽

O.A. Yarmak ◽

◽

...

Keyword(s):

Surgical Treatment ◽

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Subretinal Fluid ◽

Crystalline Lens ◽

Vitreous Cavity ◽

Macular Area ◽

General Group ◽

Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

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Outcomes of three surgical approaches for managing ectopia lentis in Marfan syndrome

European Journal of Ophthalmology ◽

10.1177/1120672121992950 ◽

2021 ◽

pp. 112067212199295

Author(s):

Gurkan Erdogan ◽

Nilay Kandemir Besek ◽

Betul Onal Gunay ◽

Alper Agca

Keyword(s):

Marfan Syndrome ◽

Crystalline Lens ◽

Surgical Approaches ◽

Posterior Chamber ◽

Ectopia Lentis ◽

Iol Implantation ◽

Capsular Tension Ring ◽

Group 3 ◽

Group 2 ◽

Group 1

Objective: To investigate the clinical outcomes of three surgical approaches for ectopia lentis in Marfan syndrome (MS) patients who had undergone crystalline lens removal with posterior chamber intraocular lens (IOL) implantation techniques comprising the intrascleral fixation of IOL, sutured scleral fixation of IOL, and IOL implantation with the use of a Cionni capsular tension ring (CTR). Methods: This is a retrospective comparative study, including 35 eyes of 21 patients who underwent the intrascleral fixation of IOL (group 1), scleral IOL fixation with the Z-suture (group 2), and IOL implantation with the use of a Cionni CTR (group 3) following crystalline lens removal. The surgical indications were as follows: no improvement in visual function after eyeglasses or contact lens application due to excessive irregular astigmatism and advanced crystalline lens decentration in which the edge of the crystalline lens came up to the optical axis, or dislocation of the crystalline lens resulting in aphakia and secondary glaucoma due to lens dislocation. The surgical outcomes and complications due to surgery were compared between the groups. Results: The mean age of the patients in the study was 12.3 ± 8.7 years (5–32 years). There were 10 eyes in group 1, 13 eyes in group 2, and 12 eyes in group 3. Visual acuity improved significantly in each group after surgery. Ocular residual astigmatism did not differ significantly between the groups ( p = 0.51). Conclusion: There were no significant differences between the three surgical approaches in the current study in terms of the postoperative results and complications.

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A 127 kb truncating deletion of PGRMC1 is a novel cause of X-linked isolated paediatric cataract

European Journal of Human Genetics ◽

10.1038/s41431-021-00889-8 ◽

2021 ◽

Author(s):

Johanna L. Jones ◽

Mark A. Corbett ◽

Elise Yeaman ◽

Duran Zhao ◽

Jozef Gecz ◽

...

Keyword(s):

Intellectual Disability ◽

Protein Interactions ◽

Cholesterol Biosynthesis ◽

Crystalline Lens ◽

Whole Genome Sequencing Data ◽

Mendelian Disease ◽

Cataract Formation ◽

Sequencing Data ◽

Zebrafish Model ◽

Paediatric Cataract

AbstractInherited paediatric cataract is a rare Mendelian disease that results in visual impairment or blindness due to a clouding of the eye’s crystalline lens. Here we report an Australian family with isolated paediatric cataract, which we had previously mapped to Xq24. Linkage at Xq24–25 (LOD = 2.53) was confirmed, and the region refined with a denser marker map. In addition, two autosomal regions with suggestive evidence of linkage were observed. A segregating 127 kb deletion (chrX:g.118373226_118500408del) in the Xq24–25 linkage region was identified from whole-genome sequencing data. This deletion completely removed a commonly deleted long non-coding RNA gene LOC101928336 and truncated the protein coding progesterone receptor membrane component 1 (PGRMC1) gene following exon 1. A literature search revealed a report of two unrelated males with non-syndromic intellectual disability, as well as congenital cataract, who had contiguous gene deletions that accounted for their intellectual disability but also disrupted the PGRMC1 gene. A morpholino-induced pgrmc1 knockdown in a zebrafish model produced significant cataract formation, supporting a role for PGRMC1 in lens development and cataract formation. We hypothesise that the loss of PGRMC1 causes cataract through disrupted PGRMC1-CYP51A1 protein–protein interactions and altered cholesterol biosynthesis. The cause of paediatric cataract in this family is the truncating deletion of PGRMC1, which we report as a novel cataract gene.

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