Spontaneous Anterior Lens Capsular Dehiscence Causing Lens Particle Glaucoma

To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.

Lens Particle Glaucoma with Intraocular Foreign Body

PURPOSE: To report a case of acute lens particle glaucoma with an intraocular foreign body that persisted for a long duration. CASE SUMMARY: A 47-year-old man visited our clinic due to severe pain in his right eye. His uncorrected visual acuity was hand movement, and intraocular pressure (IOP) measured by a Goldmann applanation tonometer was 76 mmHg in the right eye. Severe corneal edema and floating lens materials in the anterior chamber were revealed by slit-lamp examination. An ultrasonography scan showed that the lens had dislocated into the vitreous cavity and revealed vitreous opacities. To remove lens materials and control IOP, anterior chamber irrigation and trans pars plana vitrectomy with lensectomy were performed under local anesthesia. During the operation, an intraocular foreign body was removed from the anterior chamber. Dislocated lens particles were removed by vitrectomy. After the operation, his best corrected visual acuity was 1.0, and intraocular pressure was 12 mmHg in the right eye. CONCLUSIONS: Close observation is needed in cases with lens particle glaucoma, because a long-persisting intraocular foreign body can be accompanied by lens particle glaucoma.

Lens particle glaucoma occurring 15 years after cataract surgery

A 60-year-old man visited our clinic with a sudden blurred vision and ocular pain in his right eye occurring 15 years after cataract surgery. The intraocular pressure (IOP) was 55 mmHg in the right eye and gonioscopy revealed a wide open angle with white cortical lens material in the inferior angle. Since the IOP was unable to be controlled with medical therapy, removal of the lens material was performed by irrigation and aspiration. Following surgery, the IOP was decreased to 18 mmHg without medication and the patient's vision recovered to 20/20. The pathology of the aqueous humor showed macrophages with engulfed lens particles.