[Rare complication in microspherophakia surgery: early capsular contraction]

J Fr Ophtalmol. 2007 Dec;30(10):e30. doi: 10.1016/s0181-5512(07)79281-1.
[Article in French]

Abstract

Introduction: Microspherophakia is characterized by a decreasing equatorial diameter of the crystalline lens and a relative spherical shape objectivized by an increase in the diameter of the anteroposterior axis. This rare abnormality, leading to severe glaucoma and lenticular myopia, can be sporadic or inherited.

Observation: We report the case of an 18-year-old woman with a history of bilateral angle-closure glaucoma consulting for recurring painful episodes with no relief from medical treatment. The clinical examination showed idiopathic microspherophakia, confirmed by crystalline lens diameter measures with B-scan biometry, associated with secondary glaucoma due to pupillary blockage even though bilateral iridotomy was achieved. A lens extraction was performed with a bag implantation, with no complications. Seven days after surgery, visual acuity dropped to 10/10 with no refractive error, but a major capsular contraction and a superior haptic luxation were noted. After a new surgery to reposition the haptic, at the end of 3 months the visual acuity was 10/10 without refractive error or hypertony.

Conclusion: This report is an example of a rare crystalline lens disease that required lens extraction. Postoperative complications raise the problem of implantation in this pathology because of the small capsular bag diameters and the high rate of bag contraction. Using a capsular tension ring may prevent this complication but a ring was not placed in this case because of a particular anatomic condition (small bag).

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Female
  • Follow-Up Studies
  • Glaucoma, Angle-Closure / congenital*
  • Glaucoma, Angle-Closure / diagnostic imaging
  • Glaucoma, Angle-Closure / surgery
  • Gonioscopy
  • Humans
  • Lens Capsule, Crystalline / diagnostic imaging
  • Lens Capsule, Crystalline / pathology*
  • Lens Implantation, Intraocular*
  • Lens, Crystalline / abnormalities*
  • Lens, Crystalline / diagnostic imaging
  • Myopia / congenital
  • Myopia / surgery
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery
  • Prosthesis Failure*
  • Reoperation
  • Syndrome
  • Ultrasonography
  • Visual Acuity