Spontaneous lens subluxation into anterior chamber. Importance of an early management

Abstract Background: Spherophakia is a rare condition and compared to its occurrence with familial and systemic disorders, isolated spherophakia is even more uncommon. This rare case of isolated spherophakia will raise the alertness of physicians when dealing with a high myopia patient with shallow anterior chamber and relatively normal fundus. Case presentation: We report a case of a 17-year-old male who experienced painless decrease of vision in both eyes (OU) for 11 years, with progression of visual impairment and occasional ocular pain for one year. Examination revealed high myopia, increased intraocular pressures (IOP, 28 mmHg in the right eye (OD) and 33 mmHg in the left (OS)), shallow central anterior chambers, lenses of a spherical shape with superior subluxation, occludable angles without peripheral anterior synechiae, and healthy optic discs OU. A diagnosis of bilateral isolated spherophakia, lens subluxation, high myopia and secondary angle closure (AC) was made. Pars plana lensectomy with anterior vitrectomy and scleral suturing of an intraocular lens was performed. On postoperative follow-up at 19 days OD and 63 days OS, the visual acuity was 6/6 and the IOP was normal without any medication OU. Conclusions: A presentation with high myopia, shallow anterior chamber with a normal retina should alert the clinician to the possibility of spherophakia, as compared to high myopia caused by elongated axial length. Surgery should be considered in cases of spherophakia with AC where the IOP cannot be controlled by noninvasive means.

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Transcorneal Anterior Chamber Laser Cyclophotocoagulation for the Treatment of Secondary Glaucoma with Lens Subluxation in a Dog

Journal of the Japan Veterinary Medical Association ◽

10.12935/jvma.73.259 ◽

2020 ◽

Vol 73 (5) ◽

pp. 259-263

Author(s):

Nobuhide YOSHINO ◽

Kenichiro IKEDA

Keyword(s):

Anterior Chamber ◽

Secondary Glaucoma ◽

Lens Subluxation

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Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

10.21203/rs.2.19423/v1 ◽

2019 ◽

Author(s):

Hong-Yang Zhang ◽

Hong-Liang Lin ◽

Yong-Jie Qin ◽

Yu-Lin Zhang ◽

Yu-Qiao Zhang ◽

...

Keyword(s):

Anterior Chamber ◽

Clinical Characteristics ◽

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Acute Angle ◽

Angle Closure ◽

Fellow Eye ◽

Lens Extraction ◽

Lens Subluxation ◽

Acute Angle Closure

Abstract BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.

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Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

10.21203/rs.2.432/v4 ◽

2019 ◽

Author(s):

Xiaoli Xing ◽

Liangyu Huang ◽

Fang Tian ◽

Yan Zhang ◽

Yingjuan Lv ◽

...

Keyword(s):

Anterior Chamber ◽

Axial Length ◽

Anterior Chamber Depth ◽

Acute Angle ◽

Angle Closure ◽

Lens Subluxation ◽

Lens Thickness ◽

Primary Angle Closure ◽

Lens Position ◽

Acute Angle Closure

Abstract Background : To compare the anterior biometricsof eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), which were misdiagnosed at the first visit withacute primary angle closure (APAC), chronic primary angle closure glaucoma (CPACG), or cataracts. Methods: This retrospective case series ncluded 17 eyes with angle closure due to occult LS which were misdiagnosed with APAC at the first visit, 56 APACeyes, 54 CPACGeyes, and 56 cataracteyes. The axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD), and lens thickness (LT) were recorded. The lens position (LP), relative lens position (RLP), and corrected lens position (CLP) were calculated. Quantitative data were subject to a one-way analysis of variance and correlation analysis. Categorical data were analysed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cut-off value for ocular biometrics. Results: The ASAC-LSpatients had a longer ocular AL than the APACand CPACGpatients. The CCTinthe ASAC-LS patientsdid not significantly differ from that in the APAC patientsbut did significantly differ from that of the CPACG and cataract patients.The APAC patientshad the smallest ACD, while the ASAC-LS patientshad the smallest AD. The ASAC-LS patientshad the thickest lenses. According to the ROC curve analysis, the RLP, ACD, AD, CLP, and LP hada high power of discrimination. Conclusions: This study revealed that ASAC-LS patients had a shallower AD and thicker CCT compared to APAC, CPACG, and cataract patients. Biometric parameters ACD, ADwere characteristic of lens subluxation according to our data. The calculated parameters RLP,CLP, LP can be helpful in the differential diagnosis between ASAC-LSand APAC, CPACG, Cataract. Trial registration: NCT03752710, retrospectively registered. Keywords:Lens subluxation; Acute angle-closure; Biometry; Anterior chamber depth; Lens thickness; Axial length

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Comparison of clinical outcomes between iris-fixated anterior chamber intraocular lenses and scleral-fixated posterior chamber intraocular lenses in Marfan syndrome with lens subluxation

Clinical and Experimental Ophthalmology ◽

10.1111/j.1442-9071.2011.02612.x ◽

2011 ◽

Vol 40 (3) ◽

pp. 268-274 ◽

Cited By ~ 24

Author(s):

Danying Zheng ◽

Pengxia Wan ◽

Jingli Liang ◽

Tingting Song ◽

Yizhi Liu

Keyword(s):

Anterior Chamber ◽

Clinical Outcomes ◽

Marfan Syndrome ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Lens Subluxation

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Comparisons of Ocular Anatomic Differences of Lens-Subluxated Eye with or without Acute Angle Closure: A Retrospective Study

Journal of Ophthalmology ◽

10.1155/2020/6974202 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Hong-Liang Lin ◽

Yong-Jie Qin ◽

Yu-Lin Zhang ◽

Yu-Qiao Zhang ◽

Yong-Yi Niu ◽

...

Keyword(s):

Anterior Chamber ◽

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Acute Angle ◽

Angle Closure ◽

Lens Extraction ◽

Lens Subluxation ◽

History Of ◽

Acute Angle Closure ◽

Anatomic Basis

Purpose. To compare ocular anatomy differences of lens subluxation between eyes with or without acute angle closure (AAC). Methods. This is a retrospective and case-control study. Sixty cases with mild lens subluxation were recruited. Among them, 30 eyes with acute angle closure were assigned to the AAC group and 30 eyes without AAC were assigned to the non-AAC group. The anterior segment was quantitatively evaluated by ultrasound biomicroscopy (UBM). The axial length (AL) was measured with IOL Master. All patients underwent lens extraction surgery and were followed up for six months. Results. The history of blunt trauma accounted for 22 (73.3%) cases in the AAC group and 21 (70%) cases in the non-AAC group. Fifteen (50%) patients in the AAC group had iridotomy history, and high intraocular pressure recurred. The UBM analysis showed that the average central chamber depth of the affected eyes in the AAC group was 1.82 mm, which was significantly shallower than that in the fellow eyes (2.58 mm, P<0.05) or both eyes in the non-AAC group.Both eyes in the AAC group presented a shorter AL and shallower anterior chamber than the eyes in the non-AAC group. Conclusions. An asymmetrical anterior chamber between bilateral eyes is an important feature in lens subluxation-induced AAC. The crowded anterior chamber and shorter AL might be the anatomic basis for the eye with lens subluxation-induced AAC.

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