Clear lens phacoemulsification in Alport syndrome: refractive results and electron microscopic analysis of the anterior lens capsule

Eur J Ophthalmol. 2014 May-Jun;24(3):345-51. doi: 10.5301/ejo.5000365. Epub 2013 Oct 16.

Abstract

Purpose: To report the ocular findings of patients with Alport syndrome and the results of clear lens extraction in this patient group.

Methods: Twenty-three eyes of 15 patients with a diagnosis of Alport syndrome were included in this study. Clear corneal phacoemulsification and intraocular foldable lens implantation was performed in eyes with indeterminate refractive errors and/or poor visual acuity and anterior capsule samples were analyzed with electron microscopy.

Results: All patients had a history of hereditary nephritis and/or deafness as systemic involvement. Ophthalmologic examination revealed anterior lenticonus with high myopia and/or irregular astigmatism in all patients. The mean best-corrected visual acuity (BCVA) was 0.67 ± 0.17 logMAR (range 1.0-0.4) preoperatively and 0.17 ± 0.08 logMAR (range 0.3-0.0) postoperatively. Postoperative refractive lenticular astigmatism dramatically decreased and no ocular complications arose during the follow-up period. Transmission electron microscopic analysis of the lens capsules supported the diagnosis of Alport syndrome.

Conclusions: Clear lens phacoemulsification and foldable intraocular lens implantation is a safe and effective therapeutic choice for the management of uncorrectable refractive errors and low visual acuity due to anterior lenticonus in patients with Alport syndrome.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Capsule of the Lens / ultrastructure*
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Female
  • Humans
  • Lens Diseases / physiopathology
  • Lens Diseases / surgery*
  • Lens Implantation, Intraocular*
  • Male
  • Microscopy, Electron
  • Myopia / physiopathology
  • Myopia / surgery*
  • Nephritis, Hereditary / surgery*
  • Phacoemulsification / methods*
  • Refraction, Ocular / physiology
  • Visual Acuity / physiology
  • Young Adult