Lens nucleus dislocation in hypermature cataract: Case report and literature review

Abstract

Introduction: Hypermature cataract is a form of late-stage cataract progression that can lead to a variety of complications. Spontaneous capsular rupture with lens nucleus displacement in hypermature cataracts has rarely been reported. We describe 2 cases of spontaneous dislocation of the lens nucleus in a hypermature cataract and perform a review of the literature on this complication.Patient Concerns: We report 2 rural men aged 50 and 76 years with deteriorating vision.Diagnosis: The final diagnosis was senile hypermature cataract with dislocation of the lens nucleus in both patients and secondary glaucoma for the second patient.Interventions and Outcomes: During admission, both patients complained of deteriorating vision. Slit-lamp examination showed lens nucleus dislocation into the anterior chamber. The 50-year-old patient exhibited a residual lens capsule and a turbid cortex, with a normal anterior chamber and intraocular pressure. The 76-year-old patient presented a shrunken and ruptured capsule and no cortex in the pupillary area, mild inflammation in the anterior chamber, and high intraocular pressure. Both patients underwent intracapsular cataract extraction combined with anterior vitrectomy and achieved good postoperative recovery.Conclusion: Lens nucleus dislocation in hypermature cataracts can be seen in clinical practice, particularly in underdeveloped areas. Early recognition and surgery can improve vision.

Deslocamento espontâneo do núcleo do cristalino para câmara anterior

“…O extravasamento do córtex liquefeito do cristalino pode migrar para a CA, desencadeando uveíte induzida pelo cristalino ou glaucoma facolítico. (4,(7)(8)(9) A ruptura espontânea da cápsula anterior resultando em deslocamento do núcleo para a CA foi descrita como uma rara complicação. Alguns relatos já foram expostos associados a doenças sistêmicas, como em pacientes com síndrome de Marshall e Alport, enfatizando a necessidade de se realizar um exame clínico completo.…”