[Rare complication in microspherophakia surgery: early capsular contraction]

Area of Science:

• Ophthalmology
• Genetics

Background:

• Microspherophakia is a rare crystalline lens abnormality characterized by reduced equatorial diameter and increased anteroposterior axis, leading to glaucoma and myopia.
• This condition can be sporadic or inherited.

Observation:

• An 18-year-old woman with bilateral angle-closure glaucoma presented with recurrent painful episodes unresponsive to medical management.
• Idiopathic microspherophakia was diagnosed, causing secondary glaucoma due to pupillary blockage despite iridotomy.
• Lens extraction with bag implantation was performed, followed by visual acuity recovery but complicated by capsular contraction and haptic luxation, necessitating revision surgery.

Findings:

• Successful lens extraction and implantation were achieved, restoring visual acuity to 10/10 without refractive error.
• Significant postoperative complications included major capsular contraction and superior haptic luxation, indicating challenges with intraocular lens (IOL) implantation in microspherophakia.
• Revision surgery to reposition the haptic resolved complications, resulting in stable visual acuity and intraocular pressure at 3 months.

Implications:

• This case highlights the complexities of managing microspherophakia, particularly regarding IOL implantation due to small capsular bag dimensions and high contraction rates.
• The use of a capsular tension ring is suggested to mitigate capsular contraction, though its application may be limited by specific anatomical conditions.
• Further research into optimal surgical techniques and IOL choices for microspherophakia is warranted to improve outcomes and minimize complications.