open access

Vol 6 (2021): Continuous Publishing
Case report
Published online: 2021-07-15
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Bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s syndrome

Riyad Banayot1, Nicholas Sargent1
·
Ophthalmol J 2021;6:57-60.
Affiliations
  1. St. John Eye Hospital, Jerusalem, Palestine

open access

Vol 6 (2021): Continuous Publishing
CASE REPORTS
Published online: 2021-07-15

Abstract

Background: The purpose of this paper was to report a case of bilateral lens capsule rupture in a patient with
previously undiagnosed Alport’s syndrome.

Case presentation: A 12-years-old child was referred to our hospital for cataract extraction secondary to decreased visual acuity in the right eye two years after lensectomy and posterior chamber intraocular lens implant in the left eye secondary to assumed traumatic cataract. Slit-lamp examination showed a ruptured anterior capsule in the right eye with lens matter in the anterior chamber. Clinically the patient was anemic and deaf; he was referred for pediatric evaluation and was diagnosed with Alport’s syndrome and end-stage renal disease. Once the patient’s hypertension was controlled, a lensectomy and posterior chamber intraocular lens implant was performed.

Results: Lensectomy and posterior chamber intraocular lens implant removed the cataract and allowed the restoration
of visual acuity.

Conclusions: Ophthalmologists may be the first to consider the diagnosis of Alport’s syndrome based on lens
changes. Uncontrolled Blood pressure can delay surgery, during which time intraocular pressure (IOP) should be
monitored closely. Results of lensectomies with foldable IOL implantation are successful. To our knowledge, this
is the second report of a case of bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s
syndrome.

Abstract

Background: The purpose of this paper was to report a case of bilateral lens capsule rupture in a patient with
previously undiagnosed Alport’s syndrome.

Case presentation: A 12-years-old child was referred to our hospital for cataract extraction secondary to decreased visual acuity in the right eye two years after lensectomy and posterior chamber intraocular lens implant in the left eye secondary to assumed traumatic cataract. Slit-lamp examination showed a ruptured anterior capsule in the right eye with lens matter in the anterior chamber. Clinically the patient was anemic and deaf; he was referred for pediatric evaluation and was diagnosed with Alport’s syndrome and end-stage renal disease. Once the patient’s hypertension was controlled, a lensectomy and posterior chamber intraocular lens implant was performed.

Results: Lensectomy and posterior chamber intraocular lens implant removed the cataract and allowed the restoration
of visual acuity.

Conclusions: Ophthalmologists may be the first to consider the diagnosis of Alport’s syndrome based on lens
changes. Uncontrolled Blood pressure can delay surgery, during which time intraocular pressure (IOP) should be
monitored closely. Results of lensectomies with foldable IOL implantation are successful. To our knowledge, this
is the second report of a case of bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s
syndrome.

Get Citation

Keywords

Alport’s syndrome; anterior lenticonus; spontaneous capsule rupture

About this article
Title

Bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s syndrome

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Case report

Pages

57-60

Published online

2021-07-15

Page views

6170

Article views/downloads

383

DOI

10.5603/OJ.2021.0010

Bibliographic record

Ophthalmol J 2021;6:57-60.

Keywords

Alport’s syndrome
anterior lenticonus
spontaneous capsule rupture

Authors

Riyad Banayot
Nicholas Sargent

References (11)
  1. Hurst AF. Hereditary familial congenital hemorrhagic nephritis. BMJ. 1927; 1(3454): 504–506.
  2. Arnott EJ, Crawfurd MD, Toghill PJ. Anterior lenticonus and Alport's syndrome. Br J Ophthalmol. 1966; 50(7): 390–403.
  3. Nielsen CE. Lenticonus anterior and Alport's syndrome. Acta Ophthalmol (Copenh). 1978; 56(4): 518–530.
  4. Swann PG, Patel S. Lenticular changes in Alport's syndrome. Clin Exp Optom. 2005; 88(1): 53–54.
  5. Ruotsalainen J, Tarkkanen A. Capsule thickness of cataractous lenses with and without exfoliation syndrome. Acta Ophthalmol (Copenh). 1987; 65(4): 444–449.
  6. Ohkubo S, Takeda H, Higashide T, et al. Immunohistochemical and molecular genetic evidence for type IV collagen alpha5 chain abnormality in the anterior lenticonus associated with Alport syndrome. Arch Ophthalmol. 2003; 121(6): 846–850.
  7. Olitsky SE, Waz WR, Wilson ME. Rupture of the anterior lens capsule in Alport syndrome. J AAPOS. 1999; 3(6): 381–382.
  8. Gupta A, Ramesh Babu K, Srinivasan R, et al. Clear lens extraction in Alport syndrome with combined anterior and posterior lenticonus or ruptured anterior lens capsule. J Cataract Refract Surg. 2011; 37(11): 2075–2078.
  9. Agrawal N, Nayak DP, Haripriya A, et al. Phacoemulsification with toric IOL implantation in Alport syndrome with anterior lenticonus having spontaneously ruptured anterior capsule. Eur J Ophthalmol. 2015; 25(5): e78–e80.
  10. Boss JD, McDermott M. Capsulorhexis tearing pattern during phacoemulsification in anterior lenticonus due to Alport syndrome. Eur J Ophthalmol. 2016; 26(3): e39–e41.
  11. van der Westhuizen DP, Stuart KV. Bilateral spontaneous anterior lens capsule ruptures in a child: A rare presentation of Alport syndrome. Am J Ophthalmol Case Rep. 2020; 20: 100896.

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