title: A case of phacolytic glaucoma with anterior lens capsule disruption identified by scanning electron microscopy.
abstract: BACKGROUND
  Phacolytic glaucoma is induced by lens protein or macrophages that have leaked through a macroscopically intact anterior lens capsule. Here, we report a case of phacolytic glaucoma with anterior lens capsule disruptions visualized by scanning electron microscopy (SEM).
  
  
  METHODS
  A 71-year-old man was referred to our institute for increased intraocular pressure (IOP) in the right eye. Slit-lamp biomicroscopic examination revealed corneal edema, the presence of inflammatory cells and iridescent crystalline in the anterior chamber, and a hypermature cataract in the right eye. Despite treatment with topical glaucoma medication (0.15% brimonidine, 1% brinzolamide/0.5% timolol, and 0.03% bimatoprost) and systemic mannitol, his IOP remained uncontrolled. Light microscopy was used to examine the aqueous humor obtained via anterior chamber paracentesis and the anterior lens capsule obtained via intracapsular cataract extraction (ICCE), which revealed that the anterior lens capsule was intact. However, SEM revealed full-thickness disruptions in the anterior lens.
  
  
  CONCLUSIONS
  This is the first reported case of phacolytic glaucoma with disruptions of the anterior lens capsule confirmed by SEM.
authors.forename: Woong-Sun
authors.initials: WS
authors.lastname: Yoo
authors.forename: Byeong-Jae
authors.initials: BJ
authors.lastname: Kim
authors.forename: In-Young
authors.initials: IY
authors.lastname: Chung
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Seo
authors.forename: Ji-Myong
authors.initials: JM
authors.lastname: Yoo
authors.affiliation: Department of Ophthalmology, Gyeongsang National University, Colleage of Medicine, Jinju, South Korea. maya12kim@naver.com.
authors.forename: Seong-Jae
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D057866:Anterior Capsule of the Lens / Q000648:ultrastructure*; D001082:Aqueous Humor / Q000166:cytology; D002386:Cataract / Q000150:complications / Q000175:diagnosis*; D002387:Cataract Extraction; D003459:Crystallins / Q000009:adverse effects*; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008855:Microscopy, Electron, Scanning; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity
chemical_list: D003459:Crystallins