Cases reported "Eye Abnormalities"

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1/3. Anterior lenticonus: histological evaluation and approach for cataract surgery.

    PURPOSE: To present 2 cases of anterior lenticonus in patients without Alport's syndrome, a surgical technique of cataract extraction in eyes with anterior lenticonus, and histological results of lenticonus specimens obtained intraoperatively. SETTING: From St. Eriks eye Clinic, Karolinska Institute, Stockholm, sweden. methods: Two otherwise healthy patients presented with anterior lenticonus but no history of Alport's or other pathology. Best corrected visual acuity (BCVA) was decreased. Both patients had cataract extraction by phacoemulsification with intraocular lens implantation under topical anesthesia. Two continuous curvilinear capsulorhexes (CCCs) were created. The entire lenticonus was embedded in formaldehyde buffer 4% for histological analysis. RESULTS: In the first patient, BCVA did not improve postoperatively because of amblyopia. The patient subjectively reported a substantial improvement in visual field clarity. The surgical and postoperative course in the other patient was uneventful. The sections were positive for collagen types IV and VI, and the arrangement of the collagen fibers was highly irregular. CONCLUSION: Anterior lenticonus was detected in patients without Alport's syndrome who were otherwise healthy. A modified 2-step CCC technique can be used to make cataract surgery in such eyes safe and relatively easy.
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ranking = 1
keywords = phacoemulsification
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2/3. cataract extraction in X-linked megalocornea: a case report.

    OBJECTIVE: A case is described of a patient with X-linked megalocornea (XLM) who underwent bilateral consecutive phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. methods: A 49-year-old man referred to us for cataract extraction was found to have XLM with mosaic corneal dystrophy. Pseudoexfoliation of the lens capsule was present in the right eye. phacoemulsification was planned, and the Holladay II formula was used to calculate the IOL power. RESULTS: During phacoemulsification, anomalies of the capsule and zonule were observed bilaterally. At the last examination (follow-up 28 months OS, 13 months OD), best spectacle-corrected vision was 20/20 in both eyes, but the IOL was slightly decentered in the right eye. CONCLUSIONS: Corneal enlargement and mosaic dystrophy are obvious features of XLM. Anomalies involving the anterior structures of the eye and in particular the lens capsule and zonule are also frequent. cataract extraction with phacoemulsification and PC IOL implantation can be successful, but special attention must be paid to both surgical technique and IOL selection.
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ranking = 3
keywords = phacoemulsification
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3/3. phacoemulsification in anterior megalophthalmos.

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes.
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ranking = 2
keywords = phacoemulsification
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