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Nanophthalmos and microphthalmos clinical cases

Poster Details

First Author: P.López Lizárraga SPAIN

Co Author(s):    F. March de Ribot   A. March de Ribot   R. Bolanos Jimenez              

Abstract Details

Purpose:

To report the evolution of three patients with narrow secondary anterior chamber, cataract and nanophthamos. Nanophthalmos is an unusual congenital disorder associated with angle-closure glaucoma, cataract surgery in these patients is challenging. We present the clinical manifestations, approach and results in a group of patients.

Setting:

CONVAL, Spain

Methods:

Case 1 is a patient that arrived with cataract OU and a secondary narrow anterior chamber. The axial length of the right and left eye was 15.42 mm and 15.34 mm. Case 2 is a patient that arrived with an acute glaucoma attack secondary to pupillary block due to cataract. Ultrasonography reported an axial length of 16.01 mm, cataract surgery was decided. The third case is a patient that arrived to urgencies with athalamia OU (anterior chamber depth 1.19 and 1.69 mm respectively) and an acute glaucoma attack of the right eye. Posterior lensectomy was decided.

Results:

Case 4. A 43 year old patient with relative anterior microphthalmos with an anterior chamber depth of 1 mm, iris coloboma an cataract, she was programmed for phacoemulsification. Case5. Second eye of the previous patient, with relative anterior microphthalmos with an anterior chamber depth of 1.4 mm and iris coloboma, the nucleus could be extracted by dividing it with ultrachopper. Case 1: favorable evolution after uneventful phacoemulsification with VA improvement, opening of anterior chamber angles and 3 mmHg IOP reduction. Case 2: was done an Ahmed valve implantation due to persistent angle closure after phacoemulsification because of peripheral sinechiae. Case 3: unfavorable evolution with a postsurgical malignant glaucoma, hemorrhagic choroidal detachment and vitreous hemorrhage.

Conclusions:

Patients with nanophthalmos will always represent a medical and surgical challenge. Establishing adequate surgical indications and contraindications is important. A highly experienced surgeon is recommended and a close follow up is mandatory due to fatal complications such as spontaneous choroidal effusions or malignant glaucoma that can take place inadvertently.

Financial Disclosure:

NONE

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