A case of Weill-Marchesani syndrome with inversion of chromosome 15.
OBJECTIVE
To present a case of Weill-Marchesani syndrome with corneal endothelial dysfunction due to anterior dislocation of a spherophakic lens and corneolenticular contact.


METHODS
A 17-year-old woman presented with high myopia and progressive visual disturbance. She was of short stature and had brachydactyly. Her initial Snellen best corrected visual acuity (BCVA) was 20/50 (-sph 20.50 -cyl 3.00 Ax 180) in her right eye and 20/40 (-sph 16.00 -cyl 6.00 Ax 30) in her left eye. Slit lamp examination revealed a dislocated spherophakic lens touching corenal endothelium. A microspherophakic lens, hypoplastic ciliary body, and elongated zonules were confirmed on rotating Scheimpflug camera (Pentacam) and on ultrasound biomicroscopy. Specular microscopy showed corneal endothealial dysfunction. Systemic evaluation was performed, and chromosomal study showed 46, XX, inv (15) (q13qter). The patient was diagnosed with Weill-Marchesani syndrome.


RESULTS
Due to impending corneal decompensation, phacoemulsification and suture fixation of the intraocular lens were performed. The operation and postoperative course were uneventful. Three months postoperatively, the visual acuity was 20/30 (OD) and 20/40 (OS) without correction, and BCVA was 20/20 (+sph 0.50 -cyl 2.00 Ax 160 : OD) and 20/25 (+sph 1.50 -cyl 3.00 Ax 30 : OS). During the follow-up period, increased corneal endothelial counts, hexagonality, and decreased corneal thickness were achieved.


CONCLUSIONS
In Weill-Marchesani syndrome with a chromosomal anomaly, a dislocated spherophakic lens may cause severe corneal endothelial dysfunction due to corneolenticular contact, and prompt lensectomy is important to prevent such complications.
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Jae Lim
JL
Chung
Sun Woong
SW
Kim
Ji Hyun
JH
Kim
Tae-Im
TI
Kim
Hyung Keun
HK
Lee
Eung Kweon
EK
Kim
D000015:Abnormalities, Multiple; D000293:Adolescent; D007446:Chromosome Inversion / Q000235:genetics*; D002884:Chromosomes, Human, Pair 15; D003937:Diagnosis, Differential; D004392:Dwarfism / Q000235:genetics*; D004728:Endothelium, Corneal / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005385:Fingers / Q000002:abnormalities*; D006228:Hand Deformities, Congenital / Q000175:diagnosis / Q000235:genetics*; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods; D007906:Lens Subluxation / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D033401:Microscopy, Acoustic; D018918:Phacoemulsification / Q000379:methods; D013577:Syndrome