Burakgazi Ahmet Z, Ozbek Zeynep, Rapuano Christopher J, Rhee Douglas J
Cornea Service, Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
Cornea. 2006 Apr;25(3):361-3. doi: 10.1097/01.ico.0000178724.04070.ce.
This study was designed to report the long-term complications of iris-claw phakic intraocular lens implantation in a patient with Weill-Marchesani syndrome.
Case report and literature review.
A 26-year-old man with a history of glaucoma had bilateral phakic lens implantation for high myopia 10 years previously. Two years later, the left implant dislocated and was repositioned. Slit-lamp examination of both eyes revealed phakic implants of the iris-claw variety. There were moderate iridocorneal adhesions in the areas in which the lens haptics pinched the iris in both eyes and moderate epithelial and stromal edema over the temporal one-third of the left cornea. The crystalline lenses were clear with 3+phacodonesis OU. Dilated fundus examinations revealed bilateral severe optic nerve cupping. Crystalline lens diameters were measured at 7.5mm in the right eye and 8 mm in the left. Anterior chamber depths were 2.63 mm OD and 2.40 mm OS. Specular microscopy revealed central endothelial cell counts of 1133 and 587 cells/mm OD and OS, respectively. Axial lengths were 23.3 mm OD and 25 mm OS. Gonioscopic examination revealed bilateral angle closure with marked peripheral anterior synechiae. Based on our findings of short stature, shortened and thickened fingers, relatively normal axial length, microspherophakia, high myopia, and glaucoma, we diagnosed the patient with Weill-Marchesani syndrome.
Iris claw-lens phakic lenses may be an effective surgical alternative to correct high myopia in select patients; however, it may produce long-term complications in eyes with specific features.
本研究旨在报告1例Weill-Marchesani综合征患者虹膜爪型有晶状体眼人工晶状体植入术后的长期并发症。
病例报告及文献复习。
一名26岁有青光眼病史的男性10年前因高度近视行双眼有晶状体眼人工晶状体植入术。两年后，左眼植入物脱位并重新定位。双眼裂隙灯检查显示为虹膜爪型有晶状体眼人工晶状体。双眼晶状体襻压迫虹膜区域有中度虹膜角膜粘连，左眼颞侧角膜外1/3有中度上皮及基质水肿。晶状体透明，双眼晶状体震颤均为3+。散瞳眼底检查显示双眼严重视神经杯状凹陷。右眼晶状体直径测量为7.5mm，左眼为8mm。前房深度右眼为2.63mm，左眼为2.40mm。角膜内皮镜检查显示右眼和左眼中央内皮细胞计数分别为1133个/mm和587个/mm。眼轴长度右眼为23.3mm，左眼为25mm。房角镜检查显示双眼房角关闭，周边前粘连明显。根据患者身材矮小、手指短粗、眼轴长度相对正常、小晶状体、高度近视及青光眼等表现，诊断为Weill-Marchesani综合征。
虹膜爪型人工晶状体可能是矫正部分患者高度近视的一种有效手术方式；然而，对于具有特定特征的眼睛可能会产生长期并发症。
