Clear Lens Phacoemulsification with Continuous Curvilinear Capsulorhexis and Foldable Intraocular Lens Implantation for the Treatment of a Patient with Bilateral Anterior Lenticonus due to Alport Syndrome

Abstract

The case of a 29-year-old man is reported who presented with a gradually progressive, painless decrease in vision over 10 years. Anterior segment examination with a slit lamp revealed anterior lenticonus in both eyes. The patient had previously been diagnosed with bilateral sensorineural deafness, however investigations revealed microscopic haematuria and renal insufficiency that subsequently led to a diagnosis of classical Alport syndrome. Since the patient's quality of vision was severely affected by the bulging anterior lens capsule, surgical treatment was required. Clear lens phacoemulsification with continuous curvilinear capsulorhexis and foldable intraocular lens implantation were performed in each eye 2 days apart. One week after surgery, visual acuity was excellent in both eyes. Clear lens phacoemulsification with continuous curvilinear capsulorhexis and foldable intraocular lens implantation was a safe and effective therapeutic choice in this patient for the management of anterior lenticonus due to Alport syndrome.

Keywords

Alport syndrome Anterior lenticonus Phacoemulsification Intraocular lens implantation

References

Sohar

: A heredo-familial syndrome characterized by renal disease, inner ear deafness, and ocular changes. Harefuah 1954; 47: 161–162.

Flinter

Chantler

: Alport's syndrome: Inheritance and clinical features. In: Inheritance of Kidney and Renal Tract Disease ( Spitzer

Auner

, eds). Boston: Kluwer Academic, 1990; p 107.

John

Noblitt

Coots

: Clear lens extraction and intraocular lens implantation in a patient with bilateral anterior lenticonus secondary to Alport's syndrome. J Cataract Refract Surg 1994; 20: 652–655.

Jais

Knebelmann

Giatras

: X-linked Alport syndrome: Natural history and genotype–phenotype correlations in girls and women belonging to 195 families: A ‘European Community Alport Syndrome Concerted Action’ study. J Am Soc Nephrol 2003; 14: 2603–2610.

Junk

Stefani

Ludwig

: Bilateral anterior lenticonus: Scheimpflug imaging system documentation and ultrastructural confirmation of Alport syndrome in the lens capsule. Arch Ophthalmol 2000; 118: 895–897.

Sukhija

Saini

Jain

: Phacoemulsification and intraocular lens implantation in an Alport's syndrome patient with bilateral anterior and posterior lenticonus. J Cataract Refract Surg 2003; 29: 1834–1836.

Colville

Savige

: Alport syndrome. A review of the ocular manifestations. Ophthalmic Genet 1997; 18: 161–173.

Alport

: Hereditary familial congenital haemorrhagic nephritis. BMJ 1927; 1: 504–506.

Arnott

Crawfurd

Toghill

: Anterior lenticonus and Alport's syndrome. Br J Ophthalmol 1966; 50: 390–403.

10.

Kashtan

: Alport syndrome. An inherited disorder of renal, ocular, and cochlear basement membranes. Medicine (Baltimore) 1999; 78: 338–360.

11.

Zare

Rajabi

Ahmadabadi

M Nili

: Phacoemulsification and intraocular lens implantation in Alport syndrome with anterior lenticonus. J Cataract Refract Surg 2007; 33: 1127–1130.

12.

Grondalski

Bennett

: Alport's syndrome: Review and case report. Optom Vis Sci 1989; 66: 396–398.

13.

Mavrikakis

Zeilmaker

Wearne

: Surgical management of anterior lenticonus in Alport's syndrome. Eye 2002; 16: 798–800.

14.

Kato

Watanabe

Nakayasu

: The ultrastructure of the lens capsule abnormalities in Alport's syndrome. Jpn J Ophthalmol 1998; 42: 401–405.

15.

Choi

Bae

: Anterior lens capsule abnormalities in Alport syndrome. Korean J Ophthalmol 2005; 19: 84–89.

16.

Aslanzadeh

Gharabaghi

Naderi

: Clear lens phacoemulsification in the anterior lenticonus due to Alport syndrome: Two case reports. J Med Case Reports 2008; 2: 178.