PMC4724150_01
a Preoperative anterior segment of the patient's left eye. Slit-lamp examination revealed absence of the crystalline lens and deep anterior chamber. b Preoperative fundus image of the left eye. The luxated lens in the vitreous cavity can be seen stuck to the optic disc. The patient's visual acuity in that eye was 20/400. c B-mode ultrasonography findings. No movement of the luxated lens was observed in relation to changes in the patient's head position or eye movement
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Fig1
Slit-lamp examination revealed the absence of crystalline lens and deep anterior chamber (Fig. 1a). A fundus examination revealed that the patient's luxated lens had become stuck on the optic disc and obstructed the macular region, thus causing a marked visual disturbance (Fig. 1b). B-mode ultrasonography showed no movement of the luxated lens in the vitreous cavity in relation to changes in the patient's head position or eye movement (Fig. 1c).
a Image showing the intraoperative findings. An aggregation of vitreous gel (arrows) on the optic disc was found. The luxated lens probably became stuck on the optic disc via this residual vitreous gel. b An illustration depicting this mechanism
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Fig2
However, we observed an aggregation of vitreous gel between the luxated lens and the optic disc (Fig. 2a and b).
a Postoperative anterior segment of the patient's left eye. Slit-lamp examination revealed no new changes. b Postoperative funduscopic image of the left eye. Following vitreous surgery, the macula could be visualized and the corrected visual acuity in that eye had improved to 20/25
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Fig3
IOP remained at approximately 16 mmHg without additional treatment. In addition, slit-lamp examination revealed no new changes (Fig. 3a). A funduscopic examination revealed a slightly small optic disc (disc macula to disc diameter ratio 0.3), but no congenital anomalies such as an optic disc pit or morning glory syndrome (Fig. 3b).