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Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation
PURPOSE: To report three patients with an uncommon delayed complication of cataract extraction: corneal edema following dispersion of calcific lens particles from a degenerating Soemmering ring cataract. OBSERVATIONS: We report three patients, 75–92 years old, presenting with corneal edema and dispe...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663856/ https://www.ncbi.nlm.nih.gov/pubmed/36393913 http://dx.doi.org/10.1016/j.ajoc.2022.101738 |
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author | Safran, Jordan P. Nataneli, Nathan Vazirani, Jayesh Eagle Jr, Ralph C. Milman, Tatyana |
author_facet | Safran, Jordan P. Nataneli, Nathan Vazirani, Jayesh Eagle Jr, Ralph C. Milman, Tatyana |
author_sort | Safran, Jordan P. |
collection | PubMed |
description | PURPOSE: To report three patients with an uncommon delayed complication of cataract extraction: corneal edema following dispersion of calcific lens particles from a degenerating Soemmering ring cataract. OBSERVATIONS: We report three patients, 75–92 years old, presenting with corneal edema and dispersed, degenerated calcific lens material in the anterior chamber and vitreous 20–30 years after cataract surgery. In all patients, calcific particles studded the posterior surface of the cornea in a gravity-dependent distribution without apparent inflammation and were associated with localized corneal edema. In one patient, calcific particles were also associated with secondary open angle glaucoma. Deposits originated from the calcified Soemmering ring cataract. Histopathological examination demonstrated extracellular calcific deposits compatible with cataractous lens material on the posterior surface of stripped Descemet membrane of two patients. The deposits were associated with prominent localized loss of corneal endothelium and were not associated with inflammation. Morphologically similar acellular material was identified in the biopsied aqueous and vitreous fluid of one patient. Management included endothelial keratoplasty, anterior chamber lavage, pars plana vitrectomy, aspiration/removal of a portion of Soemmering ring cataract without intraocular lens implant explantation, and the removal of the entire capsular bag/implant complex. Cornea cleared and visual acuity improved in both patients who underwent endothelial keratoplasty. Persistent elevated intraocular pressure led to visual deterioration in one patient with secondary glaucoma. CONCLUSIONS AND IMPORTANCE: Dispersion of calcific Soemmering ring cataract can occur decades following cataract surgery leading to corneal edema, secondary glaucoma, and vitreous opacities. Timely recognition of this phenomenon may prevent ocular morbidity, including corneal edema and glaucoma. |
format | Online Article Text |
id | pubmed-9663856 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-96638562022-11-15 Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation Safran, Jordan P. Nataneli, Nathan Vazirani, Jayesh Eagle Jr, Ralph C. Milman, Tatyana Am J Ophthalmol Case Rep Case Report PURPOSE: To report three patients with an uncommon delayed complication of cataract extraction: corneal edema following dispersion of calcific lens particles from a degenerating Soemmering ring cataract. OBSERVATIONS: We report three patients, 75–92 years old, presenting with corneal edema and dispersed, degenerated calcific lens material in the anterior chamber and vitreous 20–30 years after cataract surgery. In all patients, calcific particles studded the posterior surface of the cornea in a gravity-dependent distribution without apparent inflammation and were associated with localized corneal edema. In one patient, calcific particles were also associated with secondary open angle glaucoma. Deposits originated from the calcified Soemmering ring cataract. Histopathological examination demonstrated extracellular calcific deposits compatible with cataractous lens material on the posterior surface of stripped Descemet membrane of two patients. The deposits were associated with prominent localized loss of corneal endothelium and were not associated with inflammation. Morphologically similar acellular material was identified in the biopsied aqueous and vitreous fluid of one patient. Management included endothelial keratoplasty, anterior chamber lavage, pars plana vitrectomy, aspiration/removal of a portion of Soemmering ring cataract without intraocular lens implant explantation, and the removal of the entire capsular bag/implant complex. Cornea cleared and visual acuity improved in both patients who underwent endothelial keratoplasty. Persistent elevated intraocular pressure led to visual deterioration in one patient with secondary glaucoma. CONCLUSIONS AND IMPORTANCE: Dispersion of calcific Soemmering ring cataract can occur decades following cataract surgery leading to corneal edema, secondary glaucoma, and vitreous opacities. Timely recognition of this phenomenon may prevent ocular morbidity, including corneal edema and glaucoma. Elsevier 2022-11-11 /pmc/articles/PMC9663856/ /pubmed/36393913 http://dx.doi.org/10.1016/j.ajoc.2022.101738 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Safran, Jordan P. Nataneli, Nathan Vazirani, Jayesh Eagle Jr, Ralph C. Milman, Tatyana Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title | Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title_full | Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title_fullStr | Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title_full_unstemmed | Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title_short | Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation |
title_sort | corneal edema associated with degenerating soemmering ring cataract: clinical-pathologic correlation |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663856/ https://www.ncbi.nlm.nih.gov/pubmed/36393913 http://dx.doi.org/10.1016/j.ajoc.2022.101738 |
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