Pigment deposits in the retrolental space of Berger: a rare feature of pigment dispersion syndrome? / Depósitos de pigmento no espaço de Berger: uma característica rara de síndrome de dispersão pigmentar?

ABSTRACT Pigment dispersion syndrome is associated with clinical features such as Krukenberg's spindles, trabecular pigmentation, Scheie's stripe and Zentmayer's ring. Another less common feature of this syndrome is retrolental pigment deposits due to anterior hyaloid detachment or a defect in the Wieger's ligament. We present two cases of pigment deposits on the posterior lens capsule. In both cases, there is bilateral dispersion of pigment throughout the anterior segment. The retrolental deposits are unilateral in the first case and bilateral in the second. Both patients report a history of ocular trauma. This is a possible important clinical sign of pigment dispersion syndrome, rarely described.

RESUMO A síndrome de dispersão pigmentar associa-se a sinais clínicos característicos como fuso de Krukenberg, hiperpigmentação da malha trabecular, linha de Scheie e anel de Zentmeyer. Um sinal menos comum dessa síndrome é o depósito de pigmento posterior ao cristalino, que ocorre por um descolamento da hialoide anterior ou um defeito no ligamento de Wieger. Apresentamos dois casos de depósitos de pigmento posterior à cápsula posterior do cristalino. Em ambos os casos, existia dispersão bilateral de pigmento por todo o segmento anterior. No primeiro caso, os depósitos eram unilaterais e, no segundo, estavam presentes em ambos os olhos. Este pode corresponder a um sinal potencialmente importante da síndrome de dispersão pigmentar, raramente descrito.

Anatomical Barrier for Anterior and Posterior Capsular Tear Extension

We examined the anatomical barrier for both anterior capsular tear extension and posterior capsular rupture extension which are the most serious intraoperative complications during cataract surgery, using 28 human eyes obtained postmortem. An experimental radial tear, about 1.0 mm in size, was created on the 5.0 mm capsulorhexis margin in the 1st group(7 eyes). Lens nucleus was removed mechanically with hydrodissection and viscoexpression technique. Radial tear extension did not extend over the lens equator in six eyes, and in one eye stopped in front of Wieger's ligament. In the 2nd group(7 eyes), after making zonular rupture around 90 degrees, same procedures were performed. Radial tear extension stopped at the equator in four eyes, and in three eyes stopped in front of Wiegel's ligament. In the 3rd group(7 eyes), we performed capsulorhexis and routine phacoemulsification for lens nucleus and cortex removal. Then we created only a posterior capsule rupture with intact anterior hyaloid membrane and vitreous pressure was increased. Posterior capsular rupture extension stopped in front of Wieger's ligament in all seven eyes. In the 4th group(7 eyes), after creating the rupture of the posterior capsule including anterior hyaloid membrane, intraocular lens was inserted into the empty capsular bag as a perpendicular direction to the axis of the tear. Posterior capsular rupture extension passed Wieger's ligament in only one eye, but did not reach equator or anterior capsule. In this study, we found that zonules, equator portion of the capsular bag and Wieger's ligament act as anatomical barriers for anterior capsular teal extension as well as for posterior capsular rupture extension.