Yonsei Med J.  2009 Jun;50(3):452-454. 10.3349/ymj.2009.50.3.452.

Spontaneous Anterior Lens Capsular Dehiscence Causing Lens Particle Glaucoma

• Kim TH
• Kim SJ
• Kim E
• Chung IY
• Park JM
• Yoo JM
• Song JK
• Seo SW

• KMID: 1758578
• DOI: http://doi.org/10.3349/ymj.2009.50.3.452

Abstract

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.

Keyword

Hypermature cataract; lens particle glaucoma; spontaneous anterior capsular dehiscence

MeSH Terms

Aged
Cataract
Cataract Extraction
Eye Injuries/*complications/surgery
Glaucoma, Open-Angle/*diagnosis/*etiology/surgery
Humans
Male

Figure

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  Fig. 1 Slit lamp photograph of the right eye showed a dehiscence of the anterior lens capsule and the deep anterior chamber with lens particles at the inferior angle. Lens cortex material protruded through the dehiscence site of the anterior capsule.

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  Fig. 2 Gonioscopy showed the presence of wide-open angles and thick lens particles attached to the inferior trabecular meshwork.

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  Fig. 3 The anterior chamber aspirate revealed lens cortical fibers, hemosiderin laden macrophages and neutrophils (Papanicolaou stain, 400×magnification).

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