Brown-McLean Syndrome Research Articles

Case Report of Brown McLean Syndrome

Purpose: To report two rare cases of Brown McLean syndrome after cataract surgery in a patient with aphakia.Case summary: (Case 1) A 54-year-old woman with Marfan’s syndrome who had aphakia and peripheral corneal edema after left eye cataract surgery 4 years ago. The patient had an elevated lesion in the peripheral cornea without involving the central cornea, and had symptoms of pain, irritation and tearing. Specular microscopy showed normal endothelial cell density and morphology in the edematous cornea. The peripheral corneal edema improved after use of antibiotics, autoserum eyedrops and 5% NaCl eyedrops. (Case 2) A 61-year-old woman with aphakia in her left eye after bilateral cataract surgery 11 years ago, underwent surgery for a macular hole in both eyes. The patient developed peripheral corneal erosions and edema in the left eye 2 months after the surgery. Specular microscopy showed normal endothelial cell density and morphology. The peripheral corneal edema was static over the years while using 5% NaCl eyedrops and artificial tears, and did not progress to involve the central cornea.Conclusions: Brown McLean syndrome is a rare disease but the possibility should be considered if a patient with aphakia after cataract surgery has peripheral corneal edema for several years.

Brown Mc Lean Syndrome: A Case Report

Purpose: The aim of this study was to report a case of Brown-McLean syndrome (BMS). Method: A complete ophthalmic evaluation and follow up for a 77 year old patient with BMS. Result: BMS is a rare condition with corneal edema involving the peripheral cornea with orange-brown pigment deposition underlying the edematous area. The edema typically starts inferiorly and advances circumferentially to superior cornea. Central cornea remains clear in most patients. It requires no further treatment and annual follow-ups are adequate. Conclusion: Patients with BMS can rarely progress to corneal decompensation; however, they should be periodically monitored and made aware of early clinical symptoms and signs of ocular surface complications.

Brown-McLean syndrome: the role of iridodonesis.

PurposeThe aim of this study was to report a case series of Brown–McLean syndrome (BMS).MethodsThe charts of 28 patients with BMS at Ramathibodi and Rutnin Hospital from 1981 to 2015 were reviewed.ResultsBMS is a rare condition with corneal edema involving the peripheral cornea with orange-brown pigment deposition underlying the edematous area. The edema typically starts inferiorly and advances circumferentially to superior cornea. Central cornea remains clear in most patients. We report 28 patients with BMS that occurred either spontaneously or after various intraocular procedures. Ultrasound biomicroscopy was performed to demonstrate the iridocorneal relationship.ConclusionIridocorneal relationship from the ultrasound biomicroscopy study in four patients did not support previous hypothesis about the role of iridodonesis impact on corneal endothelium. Patients with BMS can rarely progress to corneal decompensation; however, they should be periodically monitored and made aware of early clinical signs of their complications.

A Case of Brown-McLean Syndrome

A Case of Brown-McLean Syndrome

Anterior stromal puncture for the treatment of Brown–McLean syndrome

Case reportThe Brown–McLean syndrome is defined by peripheral corneal edema sparing the central cornea. We report a patient with bullous annular keratopathy following phacoemulsification and implantation of posterior chamber intraocular lens. The uncorrected and best corrected visual acuity was 20/30. The patient required the use of a bandage contact lens for almost 5 years to relieve the ocular discomfort. DiscussionAnterior stromal puncture was performed using a cystotome. Two weeks after the procedure the ocular discomfort disappeared and the use of bandage contact lens was no longer required. Anterior stromal puncture is a simple procedure that is performed under the slit lamp, and can alleviate the symptoms in patients with Brown–McLean syndrome.

Annular Amniotic Membrane Transplantation as a Host Incorporated Graft in the Management of Brown–McLean Syndrome

To report the use of annular amniotic membrane transplantation as a host incorporated graft in the management of Brown-McLean syndrome. Case report. An 87-year-old man underwent annular amniotic membrane transplantation with ethylenediaminetetraacetic acid chelation resulting in resolution of pain, irritation, and foreign body sensation, and resolution of recurrent peripheral epithelial defects. Annular amniotic membrane transplantation is a safe and effective treatment strategy for the management of Brown-McLean syndrome.

Micropunción estromal anterior como tratamiento del síndrome de Brown-McLean

Case reportThe Brown-McLean syndrome is defined by peripheral corneal edema sparing the central cornea. We report a patient with bullous annular keratopathy following phacoemulsification and implantation of posterior chamber intraocular lens. The uncorrected and best corrected visual acuity was 20/30. The patient required the use of a bandage contact lens for almost 5 years to relieve the ocular discomfort. DiscussionAnterior stromal puncture was performed using a cystotome. Two weeks after the procedure the ocular discomfort disappeared and the use of bandage contact lens was no longer required. Anterior stromal puncture is a simple procedure that is performed under the slit lamp, and can alleviate the symptoms in patients with Brown-McLean syndrome.

Corneal Endothelium in Brown-McLean Syndrome: In-vivo Confocal Microscopy Finding

When Brown-McLean syndrome (BMS) was first described, there was no confocal microscopy to document corneal endothelial status, and it was understood as a disease entity involving a diseased endothelial layer. In the advent of confocal microscopy demonstrating healthy endothelium in BMS within the affected cornea, it can be inferred that BMS is a spectrum of disease ranging from healthy to decompensated corneal endothelium, rather than just a specific disease entity. Here we report a case of BMS with normal healthy corneal endothelium using corneal confocal microscopy. Any patient with BMS should be followed up to observe for any disease progression and should be educated regarding the signs and symptoms of corneal surface problems. Confocal microscopy documentation is a convenient and informative way and should form part of the follow-up of any BMS patient.

Brown-McLean syndrome

Background Brown-McLean syndrome is a rare corneal presentation usually resulting from intracapsular cataract extraction or multiple anterior segment surgeries and the passage of time. Case reports Two patients presented to our clinic with Brown-McLean syndrome. Both had undergone intracapsular cataract extraction with peripheral iridectomies many years before their current examinations. Conclusions Brown-McLean syndrome can be overlooked or misdiagnosed. Although intracapsular cataract extraction is rare in this country today, eye doctors should be made aware of its presence and potential side effects.

Síndrome de Brown-McLean con lente intraocular de cámara anterior: descripción de un caso

We report one case of Brown-McLean syndrome. In this case, a 71-year-old male developed a Brown-McLean syndrome after implantation of an anterior chamber lens in one aphakic eye. A phacoemulsification procedure was performed in the other eye without development of corneal clearance alterations in the next 7 years. The cause of Brown-McLean syndrome is still unexplained. It is possible that it could develop in eyes with a genetic predisposition when these eyes are exposed to certain conditions, such as insertion of an anterior chamber lens.

Atypical clinical presentations of Brown–McLean syndrome

Atypical clinical presentations of Brown–McLean syndrome

Anterior stromal puncture in Brown-McLean syndrome

We describe 2 cases of Brown-McLean syndrome with corneal edema successfully treated by anterior stromal puncture (ASP). Ophthalmologic examinations showed peripheral edema and aphakia in both patients. The patients had ASP to control the severe foreign-body sensation. The procedure was effective over a long-term follow-up, suggesting that peripheral ASP may be an effective therapeutic option for patients with symptomatic Brown-McLean syndrome.

In vivo confocal microstructural analysis and surgical management of brown-mclean syndrome associated with spontaneous crystalline lens luxation

We report 3 members of an extended family who presented with bilateral peripheral corneal edema consistent with Brown-McLean syndrome. On clinical examination, all eyes demonstrated normal central corneas and marked peripheral edema. In vivo confocal microscopy of the peripheral cornea highlighted similar observations in the 6 eyes including endothelial pigmentation, masked stromal structure due to edema, prominent nerves, and localized basal epithelial edema. In the central cornea, in vivo confocal microscopic observations highlighted large cellular structures with prominent nuclei in groups consisting of several cells of similar appearance. In vivo confocal microscopy may enhance the diagnosis of Brown-McLean syndrome and may be used for dynamic evaluation and postoperative follow-up of the structural corneal changes.

Cataract surgery in a patient with Brown-McLean syndrome

The Brown-McLean syndrome is defined by corneal edema that involves the peripheral 2.0 to 3.0 mm of cornea, sparing the central cornea. This syndrome is usually associated with previous cataract surgery but has been reported rarely in patients with other predisposing factors such as angle-closure glaucoma or spontaneous lens absorption with iridodonesis. We describe the clinical course of a 50-year-old man with myotonic dystrophy who had Brown-McLean syndrome with no identifiable predisposition for peripheral corneal edema. Although this syndrome appears to be the result of peripheral endothelial dysfunction, this patient was able to tolerate cataract extraction without developing central corneal edema.

Brown-McLean Syndrome Occurring in a Corneal Graft

To present a case of Brown-McLean syndrome occurring in a transplanted cornea. Retrospective case report. A patient had penetrating keratoplasty performed for bullous keratopathy 6 years after intracapsular cataract extraction in the right eye. She developed atypical Brown-McLean syndrome in the left eye 6 years after extracapsular cataract extraction with pupil-support intraocular lens (IOL) insertion and later IOL removal. The clear corneal graft in the right eye developed peripheral stromal and epithelial edema with pigmentation of the endothelium, consistent with Brown-McLean syndrome 9 years after keratoplasty. Brown-McLean syndrome can occur in a grafted cornea, although the features may differ from those seen in ungrafted corneas.

Clinical Findings in Brown-McLean Syndrome

The Brown-McLean syndrome is a clinical condition with corneal edema involving the peripheral 2 to 3 mm of the cornea. The edema typically starts inferiorly and progresses circumferentially, but spares the central portion of the cornea. Additionally, the edema is associated with a punctate orange-brown pigmentation on the endothelium underlying the edematous areas. Central cornea guttata is frequently seen. This condition occurs most frequently after intracapsular cataract extraction, but may also occur after extracapsular cataract extraction and phacoemulsification, or pars plana lensectomy and vitrectomy. Surgical complications and multiple intraocular procedures are frequently observed in these patients. Less frequently, the Brown-McLean syndrome can occur in eyes that have not had surgery. We studied the clinical characteristics of 43 affected eyes of 32 patients. New findings included Brown-McLean syndrome occurring in two eyes of a phakic patient with intermittent angle-closure glaucoma. Two eyes developed Brown-McLean syndrome after phacoemulsification and one eye developed peripheral edema after pars plana vitrectomy and lensectomy. Additionally, severe, infectious keratitis occurred after rupture of peripheral bullae in two eyes. Patients with this condition should be examined periodically and educated regarding the early clinical signs of corneal ulceration.

New Clinical Findings in Brown-McLean Syndrome

New Clinical Findings in Brown-McLean Syndrome

Peripheral corneal oedema following cataract extraction (Brown-McLean syndrome).

We describe the clinical features of 21 eyes of 15 patients who developed peripheral bullous corneal oedema following cataract extraction. The peripheral oedema was asymptomatic in all cases and was only noted at a review examination. Although the onset of the peripheral oedema was probably delayed for several years after surgery, it was not documented to progress in any patient or to involve the central cornea. Endothelial specular microscopy did not reveal any endothelial features that are specific for this condition, but confirmed that the central endothelial cell density can be as high as 2150 cells/mm2 in the presence of peripheral corneal decompensation. Despite the surface irregularity resulting from the peripheral corneal oedema 12 patients (18 eyes) continued to wear contact lenses to correct their aphakia.

Brown-McLean Syndrome

Brown-McLean syndrome has been reported as a late complication, usually occurring 6 to 16 years after intracapsular and extracapsular cataract extractions. 1-3 To our knowledge, our patient's onset of symptoms 34 years after cataract extraction represents the longest interval between cataract surgery and development of symptoms due to Brown-McLean syndrome. Report of a Case. —A 52-year-old man presented complaining of a foreign body sensation in his right eye. He had undergone an intracapsular lens extraction 34 years previously for a traumatic cataract of the right eye. Best corrected visual acuity was 20/25 OU. Slit-lamp examination of the right eye revealed peripheral epithelial and stromal corneal edema with a central clear zone (4 mm horizontally and 6 mm vertically) (Fig 1) and orange pigmentation along the endothelial surface of the involved areas (Fig 2). There was a large superior sector iridectomy; the anterior hyaloid face was intact. The left eye was