Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance
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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Microspherophakia managed with phacoemulsification and endocapsular intraocular lens implantation

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Session Details

Session Title: Presented Poster Session: Congenital Cataract Surgery

Session Date/Time: Saturday 10/09/2016 | 09:30-10:50

Paper Time: 09:40

Venue: Poster Village: Pod 1

First Author: : U.Inan TURKEY

Co Author(s): :    E. Norman   E. Ertan   R. Duman   S. Inan     

Abstract Details

Purpose:

Microspherophakia is a rare bilateral developmental anomaly of the crystalline lens. Lens is smaller and spherical in-shape. It can occur as a component of familial disorder or in isolation. It can cause lenticular myopia and elevation in intraocular pressure (IOP). Angle closure glaucoma is the most important reason of visual loss. Several surgical options are exist for the management. Most cases undergone complete lensectomy and scleral fixated intraocular lens (IOL) implantation. The aim of this case report is to describe management of bilateral microspherophakia causing glaucoma and high myopia with endocapsular phacoemulsification and in-the-bag IOL implantation.

Setting:

Kocatepe University Medical School Department of Ophthalmology

Methods:

Nine-year-old female child presented with lenticular myopia, lens dislocation and glaucoma. Crystalline lens surgery was planned in both eyes. In the operation of the right eye, after continuous curvilinear capsulorhexis (CCC) and hydro-dissection, standard capsular tension ring (CTR) was implanted in the bag. Clear lens was aspirated by bimanual irrigation-aspiration. A-foldable hydrophobic-acrylic IOL was implanted into the bag. Posterior CCC with anterior vitrectomy was performed by 25-gauge vitrectome through pars-plana. Same surgery was performed in the left eye but a modified Cionni CTR was implanted in the bag and it was sutured to the sclera to stabilize the capsular complex.

Results:

The patient’s best-corrected visual acuity (BCVA) was 20/32 in both eyes at presentation. Her refraction was (-16.00-1.50x95°) and (-16.00-1.50x70°) in the right and left eye, respectively. IOP was 16-mmHg in the right and 17-mmHg in the left eye. She was under the treatment with topical dorzolamide-timolol maleate combination. Postoperative BCVA was 20/20 with cylindrical refraction of (-1.00x100°dioptre) in the right and 20/20 with cylindrical refraction of (+1.00x160°dioptre) in the left eye at month-1. Her IOP was 14-mmHg in the right eye and 15 mmHg in the left eye without medical treatment. The patient’s IOL-capsule complex was stabile and centralised with good vision at month-6.

Conclusions:

Congenital microspherophakia can cause high myopia and predispose to the glaucoma. Lens surgery with CTR (preferably with Cionni), phacoemulsification and in-the-bag IOL implantation with posterior CCC and anterior vitrectomy may be good option for the management. After the surgery IOP usually is normalise and refractive state of near-emmetropia can be achieved.

Financial Disclosure:

NONE

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