Surgical Management Of Bilateral Subluxated Spherophakic Lens With Secondary Glaucoma

Published 2022 - 40th Congress of the ESCRS

Reference: PO019 | Type: Case report | DOI: 10.82333/mdyn-w849

Authors: Yosra Abid* ¹ , Meriem Ouederni ¹ , Yosra Falfoul ² , Rym Maamouri ¹ , Monia Cheour ¹

¹Ophthalmology,Habib Thameur Hospital,tunis,Tunisia, ²Ophthalmology,Hedi Rais Institute of Ophthalmology ,tunis,Tunisia

To report the surgical management of bilateral subluxated spherophakic lens complicated with

secondary angle closure glaucoma managed with lensectomy and retropupillary iris-clow IOL

implantation in a child.

Department of ophthalmology, Habib Thameur University hospital, Tunis.

A 6-year-old boy was referred for bilateral subluxated spherophakia complicated with

secondary angle closure glaucoma. Best-corrected visual acuity (BCVA) was limited to

20/200 (-18,00 (-2,50 à 05°)) in the right eye (OD), and limited to counting fingers (-16,50 (-

2,75 à 174°)) in the left eye (OS). Slit-lamp examination revealed bilateral megalocornea

(12,5 mm) and iridophacodonesis. Intraocular pressure (IOP) was 24 mmHg in the OD and 26

mmHg in the OS under 3 antiglaucoma drops. Fundoscopy showed revealed cup to disc ratios

of 0.8 OD and 0.9 OS.

Phacoemulsification after stabilizing the capsular bag with iris retractors, anterior vitrectomy,

and retropupillary iris-clow IOL implantation were performed in the right eye. The patient

underwent the same procedure in the left eye one month later.

BCVA increased to 20/50 in the OD and 20/100 in the LE. IOP decreased to 14 mmHg OD

and 16 mmHg OG under one pressure lowering drop at 3 months follow up.

Lensectomy removal with intraocular lens implantation is an effective treatment for managing secondary angle closure glaucoma in case of subluxated spherophakic lens. It also allows treating secondary high myopia that can lead to amblyopia in children.