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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Urgent cataract surgery in a child diagnosed with Alport syndrome with acute angle-closure glaucoma secondary to spontaneous anterior lenticonus rupture

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Session Details

Session Title: Moderated Poster Session 04: Special Cases on Cataract Surgery: Paediatric

Session Date/Time: Tuesday 13/09/2016 | 14:00-15:00

Paper Time: 14:40

Venue: Poster Village: Pod 1

First Author: : G.Ciufo SPAIN

Co Author(s): :    A. Garcia-Layana   J. Barrio Barrio   M. Saenz De-Viteri        

Abstract Details

Purpose:

Anterior lenticonus is a frequent ocular finding in patients with Alport Syndrome (AS). It appears during the second to third decade of life and is uncommon in the childhood. It produces progressive vision loss and cataract formation and there are only few cases described of spontaneous lenticonus rupture and none of them in patients younger than 18 years-old. We report the outcome of a rare case of urgent phacoemulsification in a 10 years-old child with AS which presented an acute angle-closure glaucoma due to a spontaneous lens anterior capsule rupture and a swelling cataract.

Setting:

Ophthalmology Department, Clínica Universidad de Navarra, Pamplona (Spain)

Methods:

A 10 years-old child presented with a severe pain in the right eye (RE), vision reduction, photophobia, and nausea about 6 hours ago. He was diagnosed of anterior lenticonus in the RE four months before and had partial bilateral deafness and proteinuria. Ophthalmic examination revealed an acute angle-closure glaucoma due to lens capsule rupture and cataract formation with subsequent pupillary block. He was first treated with ocular hypotension medication with no success and then underwent urgent cataract extraction to restore normal tension and visual acuity.

Results:

The surgery was carried out without any complication and a foldable one-piece aspheric intraocular lens (Model: SN60WF) was implanted in the capsular bag. Then a 23-gauge pars plana vitrectomy was realized to perform posterior capsulotomy. After 14 months follow-up the child has a BCVA of 0.00 logMAR and no ocular consequences.

Conclusions:

In contrast to deafness and kidney involvement, anterior lenticonus is a rare finding of AS in the childhood, but it has always to be ruled out as we found in this case. Unlike several cases described in the literature of adult patients with AS that suffered spontaneous anterior capsule rupture which was treated with simple clear lens extraction, our patient developed severe ocular complications that needed an urgent cataract surgery. He was successfully treated and it was possible to reach good visual and anatomical results.In conclusion we were able to get a complete recovery of the patient’s eye condition.

Financial Disclosure:

NONE

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