Posters

Spontaneous subluxation of crystalline lens in pigment dispersion syndrome: a case report

Poster Details

First Author: V. Veerwal INDIA

Co Author(s):    J. Goyal   P. Jain   N. Meel              

Abstract Details

Purpose:

Pigment dispersion syndrome (PDS) is a condition that results from idiopathic atrophy of pigment layers of iris with liberation of pigment, which is carried forward and deposited along the routes of aqueous flow. Even with diffuse pigment deposition on zonular fibres, no zonular weakness or laxity has been reported in cases of PDS. By means of this case report, we present a unique case of spontaneous subluxation of crystalline lens in isolated PDS.

Setting:

This case was seen at a tertiary eye care centre in New Delhi, India

Methods:

We report an unusual case of a 43 years old male patient who presented with blurring of vision in his right eye for 6 months. There was no history of trauma. Patient underwent a comprehensive Ophthalmological and systemic evaluation. A diagnosis of PDS with no systemic association with a spontaneously subluxated crystalline lens was made. Patient underwent right eye intracapsular lens extraction with scleral fixation of posterior chamber intraocular lens (IOL) by ab-interno technique. The surgery was uneventful.

Results:

Preoperatively, patient had a best corrected visual acuity (BCVA) of 0.7 logMAR in his right eye and 0.0 logMAR in left eye. Slit lamp examination revealed a typical Krukenberg Spindle with a deep anterior chamber in both eyes. Pigment dispersion was seen on anterior lens capsule, zonules, as well as at the insertion of zonules on the posterior lens capsule suggestive of Zentmayer Line. On gonioscopy, heavily pigmented trabecular meshwork with concave iris configurationa was seen. Patient had more than 6 clock hours of zonular dehiscence with temporal subluxation of clear lens in right eye along with phacodonesis in left eye. Postoperatively, BCVA of 0.1 logMAR with a well centred IOL was noted at 4 weeks follow up.

Conclusions:

Zonular weakness and spontaneous subluxation of crystalline lens in cases of isolated PDS has not been reported previously. By means of this case report, we would like to highlight and recommend that a thorough assessment of zonular status should be done in all cases of PDS. Further studies are required to evaluate and understand the mechanism of zonular weakness in PDS.

Financial Disclosure:

NONE