INTUMESCENTE WHITE CATARACT

Published 2023 - 27th ESCRS Winter Meeting

Reference: P051 | Type: Free Paper Submission | DOI: 10.82333/rpww-5d86

Authors: Anass Boujaada* ¹ , YOUNES TLEMCANI ² , ELHASSAN ABDALLAH ³ , AMINA BERRAHO ³

¹Ophtalmology B,CHU Ibn sina,RABAT,Morocco, ²ophtalmology B,CHU Ibn Sina,RABAT,Morocco, ³Ophtalmology B,CHU Ibn Sina,RABAT,Morocco

Purpose

Intumescent cataract is a medical-surgical emergency. It is a rare entity in developed countries but remains frequent in our context where it represents 1% of operated cataracts.

Setting

Department of Ophthalmology B. Specialty Hospital of Rabat

Methods

This is a 75-year-old patient with a history of pseudophakia of the right eye who presented to the ophthalmic emergency with redness, pain and decreased visual acuity in the left eye dating back one week.

The ophthalmic examination of the left eye showed reduced visual acuity with positive light perception, diffuse conjunctival hyperemia, corneal edema with descemetic folds, a narrow anterior chamber with areflextic semi-mydriasis and a total white cataract, the fundus was unreachable for examination, the globe was hard to bi-digital palpation. The examination of the other eye was unremarkable. B-scan of both eyes was normal.

The patient received an intravenous infusion of mannitol in combination with an oral carbonic anhydrase inhibitor and hypotonic eye drops (Beta-blocker associated with carbonic anhydrase inhibitors and alpha2 adrenergic receptor agonist) to prepare him for lens extraction surgery.

Results

The patient underwent phacoemulsification under general anesthesia with the following intraoperative difficulties: poor dilatation, narrow CA, difficulty in performing capsulorhexis, poor visibility related to HTO

The phacoemulsification was performed without incident after a desepithelialization in order to improve the visibility with implantation in the bag of a foldable implant and closure of the keratotomy by a stitch in X.

The postoperative follow-up was favorable with a visual acuity of 6/10 with a normal ocular presure. The examination of the posterior segment showed a C/D :5/10.

Conclusion

Intumescent cataracts are the most frequent etiology of hypertonia of crystalline origin in our country. The extraction of the lens must be performed urgently because of the risk of optic nerve atrophy and endothelial damage.