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Spherophakia typically bilateral, occurs with high myopia

20 Mar 2018
Ophthalmologist performing a slit lamp exam.

Spherophakia is a rare disease and usually presents with varying degrees of subluxation of the crystalline lens, glaucoma and lenticular myopia, a recent study has found.

The researchers conducted a prospective interventional study of 13 patients with spherophakia (median age 12±12.06 years), whose outcomes and management studies were evaluated. In all 26 eyes, the most common presenting complaint was diminution of vision (n=24), followed by pain (n=5). High myopia was observed in 22 eyes.

Majority of the eyes (n=20) had some form of subluxation of the spherical lens. Shallow or irregular anterior chambers were detected in 19 eyes, with eight eyes having iridodonesis and six having frank phacodonesis. All patients had bilateral disease.

Five patients corresponding to 10 eyes had secondary glaucoma; 60 percent of the eyes had intraocular pressure (IOP) >21 mmHg. Following lensectomy, the IOP dropped to <16 mmHg. Two eyes of two patients had grade 2 corneal oedema because of glaucoma.

Lens extraction for dislocation/subluxation was performed in 23 eyes, while refractive rehabilitation using anterior chamber intraocular lenses was performed in 13 eyes. The proportion with best corrected visual acuity >6/60 jumped from 56.5 percent at baseline to 78.3 percent after operation.

Three eyes did not undergo any surgical intervention, one of which had angle closure due to pupillary block.

The current study described spherophakia as a disabling disease that usually occurs bilaterally and typically presents with a risk of long-term glaucoma and high myopia, according to researchers, adding that the condition “can be tackled by lens extraction and [intraocular lens] placement for visual rehabilitation and glaucoma treatment.”

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