Phacoemulsification and intraocular lens implantation in Alport syndrome with anterior lenticonus

Abstract

Eleven eyes of 6 patients with Alport syndrome had phacoemulsification with implantation of a single-piece acrylic hydrophobic intraocular lens (IOL) (AcrySof SA6OAT, Alcon) because of anterior lenticonus. All patients had excellent visual acuity after surgery. We recommend phacoemulsification with IOL implantation as a safe and effective procedure in patients with anterior lenticonus secondary to Alport syndrome.

Clear lens extraction in Alport syndrome with combined anterior and posterior lenticonus or ruptured anterior lens capsule

“…Most reports of CLE in Alport syndrome have shorter follow-ups. [2][3][4][5] Because we believe this is the first report of IOL decentration in an Alport-syndrome patient, it is difficult to comment on the long-term stability of IOLs in Alport-syndrome patients at this time.…”

“…1 The most frequent ocular findings in Alport syndrome are lenticular and retinal abnormalities. 2,4,11 The common ocular abnormalities are anterior lenticonus and dot-and-fleck retinopathy and the less common, posterior polymorphous corneal dystrophy, posterior lenticonus, and cataract. 1,11 Lenticonus is the conical projection of the lens, which can be anterior (more common) or posterior, and this leads to progressive lenticular myopia, as seen in our patients.…”

“…Clear lens extraction (CLE) with intraocular lens (IOL) implantation has been successfully used by many ophthalmologists and provided good postoperative vision. [2][3][4][5] Since myopia in Alport syndrome patients is lenticular and not pathological, there is minimal added risk for retinal detachment following clear lens extraction.…”

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

“…This was important as it avoided inadvertent spontaneous rupture of the lens capsule, which is thin and fragile in Alport syndrome. 11 The implant was a hydrophilic acrylic foldable one-piece intraocular lens that features four haptics for stable fixation within the capsular bag and reduces the possibility of rupture of the lens capsule. …”

Bilaterale Visusminderung bei einem jungen Mann

“…Die Visusprognose nach einer solchen Operation ist exzellent. Vorsicht ist geboten bei der Kapsulorhexis, die mittel-peripher (anstatt zentral) begonnen werden sollte, da die Linsenkapsel zentral sehr dünn und fragil ist und damit die Gefahr einer Kapselruptur oder des Auslaufens der Rhexis gegeben ist [11]. Diese erhöhte Fragilität während der Kapsulorhexis konnte auch durch elektronenmikroskopische Untersuchungen der vorderen Linsenkapsel bei Patienten mit einem Alport-Syndrom durch eine Ausdünnung und eine Dehiszenz, die VakuoZusammenfassung · Abstract len und fibrilläres Material enthalten, erklärt werden [12].…”