Abstract
Purpose To compare ocular anatomy differences of lens subluxation between eyes with or without acute angle closure (AAC). Methods This is a retrospective and case-control study. Sixty cases with mild lens subluxation were recruited. Among them, 30 eyes with acute angle closure were assigned to the AAC group and 30 eyes without AAC were assigned to the non-AAC group. The anterior segment was quantitatively evaluated by ultrasound biomicroscopy (UBM). The axial length (AL) was measured with IOL Master. All patients underwent lens extraction surgery and were followed up for six months. Results The history of blunt trauma accounted for 22 (73.3%) cases in the AAC group and 21 (70%) cases in the non-AAC group. Fifteen (50%) patients in the AAC group had iridotomy history, and high intraocular pressure recurred. The UBM analysis showed that the average central chamber depth of the affected eyes in the AAC group was 1.82 mm, which was significantly shallower than that in the fellow eyes (2.58 mm, P < 0.05) or both eyes in the non-AAC group.Both eyes in the AAC group presented a shorter AL and shallower anterior chamber than the eyes in the non-AAC group. Conclusions An asymmetrical anterior chamber between bilateral eyes is an important feature in lens subluxation-induced AAC. The crowded anterior chamber and shorter AL might be the anatomic basis for the eye with lens subluxation-induced AAC.
Highlights
Many conditions can result in lens subluxation, including congenital, developmental, traumatic, and iatrogenic zonulysis. e signs of lens subluxation include iridodonesis, phacodonesis, visibility of the lens equator, decentration of the lens, and vitreous prolapse in the anterior chamber, but not all patients with lens subluxation have the obvious signs mentioned earlier
All patients were divided into two groups, according to those with or without acute angle closure attack history. irty eyes of 30 patients with lens subluxation and acute angle closure were assigned to the AAC group. irty eyes of 30 patients with lens subluxation without acute angle closure history were assigned to the non-AAC group
Patients with mild lens subluxation and cataract were recruited in the study. e degree of lens dislocation in non-AAC group and AAC group was evaluated during cataract surgery. e classification method was described previously [5]: (1) minimal to mild lens subluxation in which the lens edge uncovers 0% to 25% of the dilated pupil; (2) moderate lens subluxation in which the lens edge uncovers 25% to 50% of the dilated pupil; and (3) severe lens subluxation in which the lens edge uncovers more than 50% of the dilated pupil
Summary
Many conditions can result in lens subluxation, including congenital, developmental, traumatic, and iatrogenic zonulysis. e signs of lens subluxation include iridodonesis, phacodonesis, visibility of the lens equator, decentration of the lens, and vitreous prolapse in the anterior chamber, but not all patients with lens subluxation have the obvious signs mentioned earlier. Many conditions can result in lens subluxation, including congenital, developmental, traumatic, and iatrogenic zonulysis. E signs of lens subluxation include iridodonesis, phacodonesis, visibility of the lens equator, decentration of the lens, and vitreous prolapse in the anterior chamber, but not all patients with lens subluxation have the obvious signs mentioned earlier. Lens subluxation will cause the movement of the lens forward or backward. For the eyes with AAC caused by lens subluxation, having no clinical signs of the zonular weakness, it is difficult to determine the zonular stability before surgery and these signs may be neglected in the clinical setting [3]. Except for an anteriorly positioned lens, differentiating the ocular anatomic difference is helpful in precisely diagnosing the eyes with lens subluxation-induced AAC. E present study was conducted to compare the ocular differences of lens subluxation between the eyes with or without AAC Except for an anteriorly positioned lens, differentiating the ocular anatomic difference is helpful in precisely diagnosing the eyes with lens subluxation-induced AAC. e present study was conducted to compare the ocular differences of lens subluxation between the eyes with or without AAC
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