Cataract Surgery in a Patient with Amyotrophic Lateral Sclerosis: A Case Report

Abstract

We report a cataract operation with complications in a patient with amyotrophic lateral sclerosis (ALS). The patient had a grade 4 mature brown cataract. Phacoemulsification with intraocular lens (IOL) implantation was planned; however, due to unexpected complications occurring during surgery, the operating technique was revised to an intracapsular cataract extraction. A very high vitreous pressure was found and therefore scleral fixating IOL was not implanted after anterior vitrectomy because of the possibility of choroidal effusion. The postoperative visual acuity improved sufficiently for the patient to communicate. Visual communication is of vital importance for an ALS patient and his caregivers. Therefore, surgery may be advisable in patients at a terminal stage with an advanced cataract, even if their general health condition may not seem appropriate for such an operation. Nevertheless, the intra- and postoperative course of the surgery may show unexpected complications and the surgeon should be prepared for such conditions.

A new potential therapeutic approach for ALS: A case report with NGS analysis

“…Of the many genes with minor involvement mentioned, our patient observed variants in SETX, SIGMAR1, and VAPB that have been previously reported. [14] Our patient expressed 4 exonic polymorphisms (rs1056899, rs2296871, rs3739922, and rs882709) that have been previously reported in SETX. SETX was also identified as a CMT-associated gene.…”

“…The usually off-label use of corticosteroids in patients with ALS can promote cataract formation and lead to vision loss. [14] The vision loss experienced by patients is therefore unlikely to be correlated with the experimental drug combinations that we trialed.…”

“…The connection between a specific gene variant and the disease is not always clear due to the limited number of patients with the variant and the limited study size, giving inconclusive results. Mejzini et al [14] compiled a comprehensive list of genes thought to play minor roles in ALS. Of the many genes with minor involvement mentioned, our patient observed variants in SETX, SIGMAR1, and VAPB that have been previously reported.…”

Pemphigus vulgaris and amyotrophic lateral sclerosis

“…Cenk Kohen and Beril Kucumen[11] described that a 53-year-old male ALS patient in 2011 whose disease had started 10 years ago. Four years after initial presentation, he developed PV.…”