Case Reports

Management of bilateral spontaneous ectopia lentis

Case Report Details

First Author: S.Neary IRELAND

Co Author(s):    K. Kennelly                    

Abstract Details

Purpose:

Herein we describe the case of a 44 year old-lady with a background of high myopia who presented with bilateral spontaneous crystalline lens subluxation.

Setting:

Case report.

Report of Case:

A 44 year old lady with a background of high myopia presented with a 3 month history of progressively worsening blurring of vision. She had no past medical history nor any relevant familial ophthalmic history. Review of systems was unremarkable and there was no history of trauma. She was found to have bilateral subluxed crystalline lenses with early lens opacities; inferotemporally od and inferonasally os. The remainder of her ophthalmic examination was normal. She underwent a left 25G pars plana vitrectomy and fragmatome lensectomy. A scleral-fixated IOL was placed using an MA60AC IOL and the Yamane technique. The patient made an excellent post-operative recovery with best corrected visual acuity improving from 6/36 to 6/6 Snellen. The patient awaits surgery on the fellow eye.

Conclusion/Take Home Message:

Ectopia lentis may occur secondary to trauma, ocular or systemic disease, or spontaneously as this case highlights. Associated ocular diseases include pseudoexfoliation syndrome, aniridia and hypermature cataract. Systemic associations include Marfan's syndrome, Homocystinuria and Ehlers-Danlos syndrome. A detailed history should be sought, paying particular attention to trauma and a personal or family history of cardiovascular or skeletal abnormalities. Progressive lens subluxation without vision impairment or complications can be managed conservatively, however surgical management is definitive. The Yamane technique is a simple, effective and minimally invasive method to achieve good IOL fixation in the absence of adequate zonular support.

Financial Disclosure:

None