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Atypical morgagnian cataract. Case report.

Claudio E Hernández-Guzmán1, Cristina Mendoza-Velásquez1

  • 1Departamento de Segmento Anterior, Fundación Hospital Nuestra Señora de la Luz, IAP, Ciudad de México, México.

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|May 31, 2022
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Summary

This case report details a rare morgagnian cataract where lens cortex diffused through an intact posterior capsule. Recognizing this unusual presentation is crucial for appropriate surgical management.

Keywords:
Anterior segmentCatarata morgagnianaGlaucoma facolíticoMorgagnian cataractOpacidad retrolentalPhacolytic glaucomaRetrolental opacitySegmento anterior

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Area of Science:

  • Ophthalmology
  • Surgical Case Reports

Background:

  • Morgagnian cataracts are characterized by liquefied cortical material within an intact or ruptured capsular bag.
  • Posterior capsule integrity is typically maintained in morgagnian cataracts, preventing significant cortical material extrusion.

Observation:

  • A 50-year-old male presented with acute pain, photophobia, and a 7-year history of visual loss.
  • Examination revealed elevated intraocular pressure (36 mmHg), opaque cornea, anterior chamber opacities, and liquefied cortical material.
  • Ocular ultrasound confirmed an intact posterior capsule with retrolental hyperechogenic material.

Findings:

  • The patient underwent phacoemulsification and trabeculectomy with maximum hypotensive treatment.
  • Surgical intervention revealed retrolental material, necessitating a posterior capsulotomy for aspiration with a vitrector.
  • This indicates diffusion of liquefied cortical material through an intact posterior capsule into Berger's space.

Implications:

  • This case highlights a rare presentation of morgagnian cataract with cortical material migration.
  • Accurate recognition of this phenomenon is essential for planning and executing safe surgical interventions.
  • Understanding this atypical pathway aids in managing complex cataract cases and preventing surgical complications.