ESCRS - PO029 - Microspherophakia: Case Report Of Cataract Extraction Of Young Woman Diagnosed With Microspherophakia And Secondary Glaucoma, First Time Diagnosed In Gyumri Medical Center

Microspherophakia: Case Report Of Cataract Extraction Of Young Woman Diagnosed With Microspherophakia And Secondary Glaucoma, First Time Diagnosed In Gyumri Medical Center

Published 2024 - 42nd Congress of the ESCRS

Reference: PO029 | Type: Case Report | DOI: 10.82333/3zb8-3a90

Authors: Gohar Varosyan* 1 , Asatur Hovsepyan 2 , Yeghishe Baghdasaryan 3 , Lusine Kambulyan 3 , Elza Sahakyan 4

1Gyumri Medical Center,Gyumri,Armenia, 2Armenian Eyecare Project, Malayan Eye Clinic,Yerevan,Armenia, 3Yerevan State Medical University,Yerevan,Armenia, 4Slavmed Medical Center,Yerevan,Armenia

Purpose

With this abstract I want to present a case of bilateral microspherophakia, with varied clinical presentations.. To show how we treated this patients and tell the results.

Microspherophakia is a rare congenital entity that is characterized by a bi-convex spherical lens with reduced equatorial diameter. This is primarily because of the developmental anomaly of zonules. The clinical manifestations can range from asymptomatic to high lenticular myopia, acute angle-closure, or chronic glaucoma. Microspherophakia is often a bilateral condition. 



 

Setting

Gyumri Medical Center Ophthalmology Service, Gyumri, Armenia

Report of case

We present a case of microspherophakia, presenting as lens subluxation and secondary glaucoma.

A 44-year-old young woman presented to the ophthalmology service, with drop of visual acuity in her both eyes and pain in the eyes

  • The Patient was complaining  of very low vision, that started from childhood and got worse over years
  • Her BCVA OU- 20/2000, IOP-37(Goldman)
  • Her past medical history was unremarkable, she takes no medications and eye drops
  • Eye examination - clear cornea, anterior chamber  shallow in superior part, and with normal depth in inferior part.
  • With dilated pupil examination( poor dilation)-  lens subluxation, absence of 80% of zonules (superior, temporal, nasal) and no clear view of fundus. 
  • WTW- 9.8 mm
  • Patient diagnosed: OU- High Myopia, Myopic Astigmatism, Cataract (nuclear sclerosis 3+), Lens  Subluxation, Microspherophakia, Secondary Glaucoma
  • IOL calculation was done with SRK-II formula, and we used monofocal hydrophobic IOL, because of local problems with toric IOL
  • Patient underwent OS- Cataract phacoemulsification and IOL Iris fixation ( A. Hovsepyan method)
  • OD-  Intracapsular cataract extraction and IOL Iris fixation (A. Hovsepyan method)
  • Both surgeries went without intraoperatve complications, without vitreous loss.
  • Postop 

BCVA OD-20/40 , IOP 17

BCVA OS- 20/60, IOP 19

Patient has postop Myopic Astigmatism

 

Now Patient is under observation.



 

Conclusion/Take home message

 

Microspherophakia is a rare, but potentially blinding disease with a variety of associated systemic syndromes and varied clinical presentations. Early identification of the disease, timely visual rehabilitation, and appropriate management of the lens and glaucoma can help us prevent blindness from this condition. Multidisciplinary care with lifelong follow-up is recommended.