Lam Jocelyn, Sifrig Bradley, Jung Hoon
Department of Ophthalmology, University of Washington, Seattle, Washington, USA.
College of Medicine, University of Florida, Gainesville, Florida, USA.
Case Rep Ophthalmol. 2018 Feb 14;9(1):149-153. doi: 10.1159/000486925. eCollection 2018 Jan-Apr.
We report an unusual case of rapid and severe anterior capsular contraction associated with secondary intraocular lens (IOL) dislocation following cataract surgery in a patient with unspecified rod-cone dystrophy.
A 68-year-old woman with a history of uncharacterized bilateral rod-cone dystrophy presented with blurry vision 1 month after cataract surgery. Best corrected visual acuity was 20/40 in the operative eye. Slit-lamp exam showed severe anterior capsular phimosis limiting view of the fundus. Our patient underwent 2 sessions of Nd:YAG anterior capsulotomy with limited success. Limited anterior vitrectomy was then performed without success due to densely adherent capsular tissue to the anterior surface of the IOL and additional secondary IOL dislocation. She ultimately underwent pars plana vitrectomy, removal of the capsular bag, and IOL exchange with a scleral fixated IOL.
Rapid and severe anterior capsular contraction following cataract surgery is rare but appears to be associated with rod-cone dystrophy.
我们报告了一例罕见病例,一名患有未明确类型的视杆-视锥营养不良的患者,白内障手术后出现快速且严重的前囊收缩,并伴有人工晶状体(IOL)脱位。
一名68岁女性,有双侧未明确类型的视杆-视锥营养不良病史,白内障手术后1个月出现视力模糊。术眼最佳矫正视力为20/40。裂隙灯检查显示严重的前囊膜狭窄,限制了眼底观察。我们的患者接受了2次Nd:YAG前囊切开术,但效果有限。随后进行了有限的前部玻璃体切除术,但由于囊膜组织与IOL前表面紧密粘连以及额外的继发性IOL脱位而未成功。她最终接受了经平坦部玻璃体切除术、囊袋摘除术以及用巩膜固定IOL进行IOL置换。
白内障手术后快速且严重的前囊收缩很少见,但似乎与视杆-视锥营养不良有关。