[Spontaneous dislocation to the anterior chamber of a lens luxated in the vitreous body: two cases].
BACKGROUND
Compared to lens luxations into the vitreous body, luxations into the anterior chamber are rare. We report on two patients in whom a lens luxation into the vitreous body was followed by a luxation into the anterior chamber.


METHODS
In a 61-year old male patient and a 47-year old female patient a lens luxation into the vitreous body occurred after a blunt ocular trauma and as a result of Marfan syndrome, respectively. During follow-up the patients presented with a spontaneous lens luxation into the anterior chamber. In both cases a YAG iridotomy and a surgical lens extraction were immediately performed.


CONCLUSIONS
As a result of whiplash-like movements of the vitreous body, a dislocation of a lens luxated into the vitreous body, into the retroiridal or intrapupillary space may occur. This may be facilitated by focally undamaged zonular fibers. The immediately retroiridal lens position may cause a pupillary block with fluid misdirection into the space behind the iris-lens diaphragm resulting in a consecutive pressure increase in this space. This pressure rise causes an anterior movement of the lens and may be followed by a complete dislocation into the anterior chamber especially in the case of coexisting traumatic mydriasis. As a result of this lens dislocation into the anterior chamber an inverse pupillary block develops. This situation necessitates an iridotomy prior to the surgical lens extraction.
Schäfer
Sabine
S
Universitäts-Augenklinik Ulm. sabvine.schaefer@medizin.uni-ulm.de
Spraul
Christoph W
CW
Lang
Gerhard K
GK
D000867:Anterior Chamber / Q000601:surgery; D005131:Eye Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery; D053685:Laser Therapy; D007906:Lens Subluxation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008382:Marfan Syndrome / Q000150:complications*; D008875:Middle Aged; D014822:Vitreous Body / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications*