Small lens for a big eye: Successful management of anterior megalophthalmos

Matalia, Jyoti; Tejwani, Sushma; Rajput, Vimal Krishna; Matalia, Himanshu

doi:10.4103/ijo.ijo_678_17

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Even in three eyes of our series with unremarkable macula, the best corrected visual acuity was not >20/80 perhaps due to ammetropic amblyopia. The age of presentation was lower in our cases as compared to previous literature [3,7,11], perhaps due to a greater referral of paediatric vitreoretinal cases to our tertiary care referral centre.…”

Section: Discussioncontrasting

confidence: 73%

“…Vail et al [1] first described this entity in middle-aged and elderly population. Thereafter, only a couple of case reports and a single series (n = 4) were reported in the paediatric population [2,3,11]. The age range at the time of development of RD was 8-34 years (mean 28 years) and 28-49 years in large series by Ahmadieh et al [3] and Dufour et al [12], respectively.…”

Section: Discussionmentioning

confidence: 99%

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Ocular abnormalities and complications in anterior megalophthalmos: a case series

Kumawat

Alam

Sahay

et al. 2019

Eye

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Objectives To describe the clinical and Scheimpflug imaging features in cases of anterior megalophthalmos (AM). Methods Retrospective record review was performed for patients with AM who presented between June 2017 and May 2018. Clinical history, slit lamp examination, Scheimpflug imaging indices (Pentacam-HR, Oculus, GmbH), dilated fundus examination and treatment records were reviewed. ResultsThe study included eight eyes of four male patients (mean age 6.5 years, range 4-10 years). Corrected distance visual acuity ranged from finger counting to 20/80. The mean horizontal corneal diameter, central corneal thickness, steep keratometry, flat keratometry, anterior chamber (AC) angle, AC depth, maximum pupil diameter and axial length were 13.8 ± 0.5 mm, 538.7 ± 68.9 µm, 42.8 ± 1.6 D, 41.4 ± 0.9D, 47.0 ± 4.2 degree, 3.8 ± 0.3 mm, 3.9 ± 0.1 mm, and 24.9 ± 0.9 mm, respectively. Posterior dislocation of crystalline lens, vitreous degeneration and rhegmatogenous retinal detachment (consequent of retinal dialysis/atrophic hole/lattice with hole) were noted in seven, eight and five eyes, respectively. Pigment dispersion glaucoma was noted in both eyes of one patient, which was managed with topical anti-glaucoma medication. Vitrectomy with silicone oil tamponade was successful in retinal reattachment in all three eyes that underwent surgery. Conclusion Scheimpflug imaging helps in demonstrating the corneal and anterior segment pathological changes in AM. The disease extends to involve the zonules, vitreous and retina as well. Ophthalmologists should be able to identify this disorder, recognise and manage the associations and complications.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Ocular abnormalities and complications in anterior megalophthalmos: a case series

Kumawat

Alam

Sahay

et al. 2019

Eye

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How many challenges we may encounter in anterior megalophthalmos with white cataract: a case report

Miao

Zhang

et al. 2019

BMC Ophthalmol

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Background Anterior megalophthalmos is a rare congenital disease which mainly features enlargement of the anterior segment. Cataract surgeries in anterior megalophthalmos can be challenging due to the anatomical anomalies while the studies upon the surgical design have been less integrated. Case presentation A 37-year-old woman presented with progressively blurred vision in the right eye after a transient fever 10 months ago. Her ocular history included hypermetropia with a spherical equivalent of + 4.00 OU. The review of systems showed bilateral varus deformity of distal interphalangeal joints on the little fingers. The patient denied family history of hereditary ocular diseases and her sister was born with uterus didelphys. On initial examinations, the corrected distance visual acuity was hand motion OD and 20/33 OS. Her intraocular pressure was 15 mmHg OD and 16 mmHg OS. Horizontal corneal diameter was 14 mm OD and 13.88 mm OS and axial length was 24.87 mm OD and 25 mm OS. Anterior segment photography showed bilateral iridal atrophy with deficiency in pupillary dilation and white cortically mature cataract in the right eye. Inspection by anterior segment optical coherence tomography indicated bilateral augmented anterior chambers with backward iridal concave on horizontal orientation. Ultrasound biomicroscopy showed partially peripheral anterior synechiae and pectinate ligaments at chamber angle in both eyes and opacified lens with the apparently elongated suspensory ligaments in the right eye. A deliberately selected 1-piece foldable intraocular lens (IOL) with frame haptics was implanted after phacoemulsification for good IOL stability. During the follow-up, the visual rehabilitation appeared relatively good and a lower degree of IOL dislocation comparing with existing reports was verified by OPD-Scan III aberrometry. Conclusions We presented the challenges and the original findings from a case of congenital anterior megalophthalmos with white cataract who underwent phacoemulsification and IOL implantation. This is the first report describing the comparison of the different IOL power calculation formulas in anterior megalophthalmos. Compared to the SRK/T and the Holladay II formulas, the Haigis formula could be a more accurate choice for the IOL calculation in anterior megalophthalmos according to our case. Moreover, the deliberate selection of IOLs is essential for IOL stability in these patients.

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Commentary: One size does not fit all

Jethani

2018

Indian J Ophthalmol

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Small lens for a big eye: Successful management of anterior megalophthalmos

Cited by 3 publications

References 8 publications

Ocular abnormalities and complications in anterior megalophthalmos: a case series

Ocular abnormalities and complications in anterior megalophthalmos: a case series

How many challenges we may encounter in anterior megalophthalmos with white cataract: a case report

Commentary: One size does not fit all

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