Lensectomy in the management of glaucoma in spherophakia

A 42-year-old woman presented with uncontrolled glaucoma despite patent peripheral iridotomies after a previous episode of acute angle-closure glaucoma. Spherophakia was diagnosed by anterior segment findings, refraction, A-scan biometry, and ultrasound biomicroscopy. Continuous curvilinear capsulorhexis, phacoemulsification, and infusion/aspiration were performed in the right eye. Attempted intraocular lens (IOL) implantation failed, and the eye was left aphakic. Six months later, the intraocular pressure (IOP) was normal without glaucoma therapy and visual acuity was 6/6 with a contact lens. The patient then had phacoemulsification in the left eye, removal of the capsular bag, anterior vitrectomy, and insertion of an anterior chamber IOL. Four months after surgery, the uncorrected visual acuity was 6/9 and the IOP was normal without glaucoma therapy.