Edit concept Question Editor Create issue ticket

Lens Dislocation

Dislocation of Lens


Presentation

  • Eyes presenting with IOL dislocation (case group) were compared with fellow eyes (control group). PARTICIPANTS: Patients from a tertiary referral practice in Mississauga, Ontario, Canada.[ncbi.nlm.nih.gov]
  • We present 2 cases of intraocular lens (IOL) dislocation that appeared shortly after the patients exercised on a vibration platform.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: We present a new type of secondary angle closure caused by an anterior dislocated capsular bag-CTR-IOL complex.[ncbi.nlm.nih.gov]
  • The ocular findings in patients with homocystinuria due to cystathionine-beta-synthetase (CBS) deficiency are reviewed and a new approach to lens surgery is presented.[ncbi.nlm.nih.gov]
  • The uveitis diagnosis, IOL type, presentation and management are discussed. RESULTS: Six patients from out of 1056 undergoing cataract surgery (0.57%) were affected.[ncbi.nlm.nih.gov]
Feeding Difficulties
  • The main clinical symptoms of these patients were: facial dysmorphic features, severe feeding difficulties, mental retardation, abnormal muscle tone, severe seizures and myoclonia. Four out of nine patients had dislocated eye lenses.[ncbi.nlm.nih.gov]
Soft Tissue Swelling
  • He has no other evidence of trauma and the remainder of his examination is within normal limits. imaging CT scan of the head, face, and cervical spine demonstrate a left lens dislocation with pre-septal soft tissue swelling surrounding the left globe[tamingthesru.com]
Aspiration
  • Principle steps of the evolved operative procedure are (1) visco-elastic stabilization of the anterior chamber; (2) small (1.5 mm) peripheral capsulorhexis; (3) manual endocapsular aspiration of lens material and removal of lens epithelium; (4) ab externo[ncbi.nlm.nih.gov]
  • From the vitreous cavity lens can be removed after total vitrectomy, either with the help of an insulated vitreous cryoprobe or by aspiration facility of vitrectomy probe (only soft cataract).[ikeyes.blogspot.com]
  • Aspiration through the silicone soft tipped cannula also has been used in the retrieval and manipulation of the IOL, but this technique may result in inadvertent vitreoretinal traction.[emedicine.medscape.com]
  • Following a hydrodissection, phacoemulsification of the nucleus and cortex aspiration were performed. The lens capsule was inflated with 1% sodium hyaluronate, and then the IOL was inserted into the capsular bag.[bjo.bmj.com]
Flexion Contracture
  • RESULTS: Pedigree analysis revealed a three generation family with eight of eleven individuals affected by early onset lens dislocation, high myopia, typical facies, frontal bossing, flexion contractures, proximal interphalangeal (PIP) joint thickening[ncbi.nlm.nih.gov]
Diplopia
  • Subluxation is one of the causes of monocular diplopia. If the luxation is complete the eye becomes markedly hyperopic and is unable to accommodate.[medical-dictionary.thefreedictionary.com]
  • Symptoms of these patients mainly included decrease in visual acuity (17 cases, 47.2%), blurred vision (16 cases, 44.4%), glare (1 case, 2.8%), diplopia (1 case, 2.8%), and halo (1 case, 2.8%).[ncbi.nlm.nih.gov]
  • Patients may also complain of monocular diplopia and are at risk of developing amblyopia, glaucoma, and retinal detachment. Ectopia lentis can be inherited as an isolated condition, usually autosomal dominant (simple ectopia lentis).[visualdx.com]
  • Uniocular diplopia may result from partial aphakia. Anterior chamber becomes deep and irregular. Iridodonesis is usually present.[ikeyes.blogspot.com]
Iridodonesis
  • These include: deep anterior chamber, aphakia in pupillary area, and iridodonesis. Ophthalmoscopic examination reveals lens in the vitreous cavity.[ikeyes.blogspot.com]
  • L21) See corectopia ; iridodonesis ; pupillary block. Fig.[medical-dictionary.thefreedictionary.com]
  • Iridodonesis — trembling or shimmering of the iris after rapid eye movements in lens dislocation. Look for associated ocular and other injuries. Look for evidence of risk factors (e.g.[lifeinthefastlane.com]
  • In the setting of lens dislocation, the patient may have trembling or shimmering of either the lens or iris, phakodenesis or iridodonesis, respectively.[tamingthesru.com]
  • Likewise, patients with subluxation may display iridodonesis, as well as focal deepening of the angle.[reviewofoptometry.com]
Chemosis
  • There is left-sided periorbital edema with subconjunctival hemorrhage and significant chemosis of the left eye. Extraocular movements are intact and his pupils are reactive, 3 mm to 2 mm, bilaterally. There is no afferent pupillary defect.[tamingthesru.com]
Frontal Bossing
  • RESULTS: Pedigree analysis revealed a three generation family with eight of eleven individuals affected by early onset lens dislocation, high myopia, typical facies, frontal bossing, flexion contractures, proximal interphalangeal (PIP) joint thickening[ncbi.nlm.nih.gov]
Beak Nose
  • Definition A syndrome characterized by dislocated crystalline lenses and anterior segment abnormalities in association with a distinctive facies involving flat cheeks and a beaked nose.[uniprot.org]
Beaked Nose
  • Definition A syndrome characterized by dislocated crystalline lenses and anterior segment abnormalities in association with a distinctive facies involving flat cheeks and a beaked nose.[uniprot.org]

Workup

  • A workup was performed that included echocardiography, serologic testing for syphilis, and urine chromatography, all of which were unrevealing.[nejm.org]
  • Workup  Cardiac evaluation for Marfan syndrome  Serum and urine levels of homocysteine or methionine for homocystinuria  Axial length measurement 32.[slideshare.net]
Hypouricemia
  • The main biochemical findings included hypouricemia, xanthinuria, an increased excretion of sulfite, thiosulfate, S-sulfocysteine, taurine and a decreased excretion of inorganic sulfate.[ncbi.nlm.nih.gov]

Treatment

  • Before surgery, 62 patients had either preexisting glaucoma (n 39) or high IOP ( 22 mm Hg) with suspected glaucoma (n 23), of whom several required preoperative IOP-lowering treatment.[ncbi.nlm.nih.gov]
  • Surgical treatment significantly improved the CDVA in our sample and was associated with a low complication rate.[ncbi.nlm.nih.gov]
  • The diagnostic challenges and treatment options are discussed in detail.[ncbi.nlm.nih.gov]
  • This report highlights the importance of early dietary restrictions and treatment.[ncbi.nlm.nih.gov]
  • It is suggested that treatment should be an iridectomy in the early stages and a lens extraction if glaucoma develops.[ncbi.nlm.nih.gov]

Prognosis

  • The prognosis of the disease is poor; various attempts at treatment were not successful so far. Prenatal diagnosis by assay of sulfite oxidase in cultured amniotic fluid cells and by direct measurement of amniotic fluid S-sulfocysteine is possible.[ncbi.nlm.nih.gov]
  • Treatment and prognosis Based on the characteristics of the IOL dislocation, there are several different approaches to repairing this issue.[asrs.org]
  • Treatment and prognosis Complications An anterior dislocation/subluxation carries greater complications than a posterior one. Such complications include: acute glaucoma corneal injury iridal injury Promoted articles (advertising)[radiopaedia.org]
  • If dislocation is partial and the lens is clear, visual prognosis is good. Traumatic lens dislocation can follow a blow to the eye.[tsbvi.edu]

Etiology

  • All charts were reviewed for etiology of dislocation, time elapsed from cataract surgery, best-corrected visual acuity (BCVA), slit-lamp examination, tonometry, and dilated fundus examination.[ncbi.nlm.nih.gov]
  • […] rupture during the initial cataract extraction procedure (23 eyes, 63.8%), trauma (5 eyes, 13.9%),neodymium-doped yttrium aluminium garnet (Nd:YAG) laser-induced dislocation (2 eyes, 5.6%), the status after vitrectomy (2 eyes, 5.6%) and unidentifiable etiology[ncbi.nlm.nih.gov]
  • etiology is capsular rupture during cataract surgery.[ophthalmologymanagement.com]
  • Pathology Etiology trauma systemic and syndromic disorders Marfan syndrome typically upwards and out most common spontaneous cause 2 homocystinuria - typically downwards Weil-Marchesani syndrome Ehlers-Danlos syndrome hereditary (or isolated) ectopia[radiopaedia.org]
  • As ectopia lentis may be the first sign of a more serious systemic disease, it is important to determine the etiology for appropriate patient management.[eyewiki.aao.org]

Epidemiology

  • Cases were identified through the Rochester Epidemiology Project. Three controls chosen from the cataract surgery cohort were matched to each IOL dislocation case by age, gender, and duration of follow-up.[ncbi.nlm.nih.gov]
  • Epidemiology Frequency United States Clinically insignificant decentration occurs in at least 25% of cases. Clinically significant decentration occurs in about 3% of the cases. The frequency of IOL dislocation ranges from 0.2-1.8%.[emedicine.medscape.com]
  • Diagnosis: Marfan syndrome with lens dislocation Differential diagnosis for crystalline lens dislocation : Trauma Homocystinuria Sulfite oxidase deficiency Weill-Marchesani Syndrome Hyperlysinemia EPIDEMIOLOGY Incidence: 1/5000 - 1/2000. 60-87% with ectopia[webeye.ophth.uiowa.edu]
Sex distribution
Age distribution

Pathophysiology

Prevention

  • Capsular tension rings probably help but do not prevent this complication. Management includes IOL exchange, replacement with an anterior or a sutured posterior chamber IOL, or suturing the IOL through the bag to the iris or the sclera.[ncbi.nlm.nih.gov]
  • Awareness, careful examination, and prompt referral to an ophthalmologist can prevent complications and preserve the patient's vision.[ncbi.nlm.nih.gov]
  • Discussed are the possible reasons for the complication and measures to prevent it.[ncbi.nlm.nih.gov]
  • The dislocated lens was removed surgically (intracapsular extraction) with the preventive basal iridectomy.[ncbi.nlm.nih.gov]
  • Capsular tension rings (CTR) are frequently used to prevent postoperative complications caused by zonular weakness.[ncbi.nlm.nih.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!