Abstract
We report the surgical management of a patient with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS) and the Optiwave Refractive Analysis (ORA) system. A 38-year-old man with Alport syndrome presented to our department with visual loss due to anterior lenticonus in both eyes. Adjustments during bilateral FLACS were performed with the software's calipers to manually delineate the anterior capsulotomy. Multifocal toric intraocular lenses (IOLs) were selected and placed in the posterior chamber with the aid of intraoperative aberrometry. The intended postoperative positioning parameters for the IOL as well as the planned visual acuity and refraction were achieved. The implementation of FLACS and intraoperative wavefront aberrometry is a safe and useful surgical approach for the management of cataract in challenging cases such as patients with anterior lenticonus due to Alport syndrome.
Highlights
We present a case of bilateral anterior lenticonus secondary to Alport syndrome that was treated with femtosecond laser-assisted cataract surgery (FLACS) and a toric intraocular lenses (IOLs) implantation whose power and orientation were verified using intraoperative aberrometry
Alport syndrome has a prevalence of 1/5000, and anterior lenticonus occurs in approximately 25% of these patients;[3] this manifestation can lead to progressive lenticular myopia and irregular astigmatism
Anterior lenticonus is not present at birth and normally develops by the second decade of life; it is bilateral in 25% of patients and can lead to rapid visual deterioration.[7]
Summary
The first pitfall is the intraocular lens (IOL) power selection and the correct positioning of the cylinder axis if a toric IOL is used, based on the corneal astigmatism.
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