J Korean Ophthalmol Soc.  2014 May;55(5):766-769. 10.3341/jkos.2014.55.5.766.

A Case of Uneventful Cataract Surgery in Idiopathic True Exfoliation Patient

• Kim GA
• Seo KY
• Ahn JM

• KMID: 2218101
• DOI: http://doi.org/10.3341/jkos.2014.55.5.766

Abstract

PURPOSE
We present a case of uneventful cataract surgery in an idiopathic true exfoliation patient with areas of capsular delamination based on scanning electron microscope and transmission electron microscope results.
CASE SUMMARY
A 77-year-old male presented with gradual deterioration of vision over 1 year in duration. Slit lamp examination revealed bilateral nuclear sclerotic cataracts with ring-shaped fibrous membrane floating within the anterior chamber in the right eye. In addition, the patient was diagnosed with cataract and true exfoliation of the right eye. He underwent uneventful phacoemulsification and posterior chamber intraocular lens implantation by placing capsulorrhexis outside the delaminated capsule margin. At 6 months after cataract surgery, the patient showed favorable visual outcome with uncorrected vision of 20/20 and intraocular pressure of 18 mm Hg in the right eye.

Keyword

Capsulorrhexis; Cataract; Idiopathic true exfoliation

MeSH Terms

Aged
Anterior Chamber
Capsulorhexis
Cataract*
Humans
Intraocular Pressure
Lens Implantation, Intraocular
Male
Membranes
Phacoemulsification

Figure

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  Figure 1. Slit lamp examination showing floating ring-shaped fibrous membrane (arrows) in the anterior chamber in the right eye (A) before dilation, (B) after dilation of the pupil, and (C) with retroillumination.

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  Figure 2. Scanning electron micrographs of the anterior lens capsule after capsulorrhexis at different magnifications. (A) At low magnification (x50). Part of the area of delamination indicated with white rectangle was re-examined at higher magnification. (B) At high magnification (x300). The arrows show the exfoliation flap.

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  Figure 3. Transmission electron micrograph of anterior lens capsule after capsulorrhexis showing the superficial layer of the anterior lens capsule (arrows) separated from the deep layer and lens epithelium (asterisk).

Reference

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