8/3/2019 Bilateral Spontaneous Anterior Dislocation of Crystalline Lens
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www.thelancet.com Vol 378 October 22, 2011 1501
Clinical Picture
Lancet 2011; 378: 1501
Published Online
August 26, 2011
DOI:10.1016/S0140-
6736(11)60313-9
Department of
Ophthalmology, Advanced Eye
Centre, Post Graduate Institute
of Medical Education and
Research, 160012 Chandigarh,
India (Prof J Ram MS,
N Gupta MS)
Correspondence to:
Prof Jagat Ram, Department of
Ophthalmology, Advanced Eye
Centre, Post Graduate Institute of
Medical Education and Research,
160012 Chandigarh, India
Bilateral spontaneous anterior dislocation of crystalline lens
in an infantJagat Ram, Nishant Gupta
A 9-month-old boy presented with photophobia of2-week duration in both eyes. There was no history oftrauma. Ocular examination showed bilateral anteriordislocation of crystalline lenses into the anteriorchamber. Examination under anaesthesia showed thedimensions of the right cornea to be 135 mm(horizontal) 130 mm (vertical) and the left cornea to be145 mm 140 mm. Intraocular pressure was 12 mm Hgin each eye. Systemic examination did not show any
abnormalities. His family history was unremarkable.The fundus was normal in both eyes. A diagnosis of
bilateral spherophakia and megalocornea with anteriordislocation of crystalline lenses was made. The crystallinelenses were removed through a limbal incision in theright eye and lensectomy with anterior vitrectomy inthe left eye. Postoperatively, the child was visuallyrehabilitated with aphakic glasses. Trans-scleral fixationof intraocular lens will be done after stabilisation of axialgrowth. Bilateral spontaneous anterior dislocation ofcrystalline lens is a rare condition in spherophakia,
necessitating prompt diagnosis and management toavoid glaucoma and corneal endothelial cell damage.
Figure:Anterior dislocation of crystalline lens
(A) Bilateral simultaneous anterior dislocation; (B) magnified view of anteriorly dislocated crystalline lens with dilated pupil.
A B