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Title:

Unilateral spontaneous lens subluxation into anterior chamber: importance of an early management


Poster Details

First Author: M. Bakkali el Bakkali SPAIN

Co Author(s):    I. Bakkali el Bakkali   J. Lara Medina   E. Mínguez Muro   F. Ascaso Puyuelo   M. del Buey Sayas        

Abstract Details

Purpose:

To describe the importance of applying an urgent protocol in cases of lens subluxation into the anterior chamber (AC) in order to diminish the risk of corneal decompensation.

Setting:

Ophtalmology department of a tertiary level University Hospital. Zaragoza. Spain.

Methods:

A 60-year-old man with a history of ocular trauma in his youth and pseudoexfoliation syndrome, who presented pupillary-block in the right eye 2 months after an accidental fall without ocular involvement. Visual acuity was 0.05 (decimal) and intraocular pressure was 55mmHg. Slit lamp examination and anterior segment optical coherence tomography showed a lens subluxation towards AC (lower portion) with endothelial contact and corneal edema. In funduscopy, an inferior giant tear with associated retinal detachment was observed.

Results:

After treating ocular hypertension with hypotensive agents, Pars Plana Vitrectomy 25 Gauge + Lensectomy + Endolaser + SF6 Tamponading gas were performed, leaving the patient in aphakia for subsequent intraocular lens implantation surgery. Two months later, a substantial loss of endothelial cell count was observed (777 cells right eye VS 2223 cells left eye).

Conclusions:

In this type of pathology, it is imperative to take immediate pharmacological, postural and surgical measures to reduce contact between the lens and the cornea, in order to minimize endothelial damage and improve the visual prognosis of these patients.

Financial Disclosure:

None




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