(2) Zonular weakness and phacodonesis
can make the capsulorhexis, phacoemulsification, irrigation/aspiration, and implantation of the IOL challenging.
Exclusion criteria included: active wet AMD; phacodonesis
; corneal guttata; axial length of greater than 24.5mm and less than 20.5mm; history of angle closure glaucoma; retinal detachment; optic neuropathy; and intraoperative surgery within the last six months.
It mainly involves the anterior segment of the eye [1, 5], where its ocular manifestations include phacodonesis
, lens subluxation, melanin dispersion, insufficient mydriasis, blood-aqueous barrier dysfunction, anterior chamber hypoxia, posterior synechiae, and corneal endothelial decompensation [1, 2, 5, 6].
A significant zonular instability can cause phacodonesis, (7) spontaneous subluxation of the lens8 (Fig.2) and angle-closure glaucoma due to pupillary and ciliary block.
If obvious phacodonesis is present, then it is advisable to insert a CTR on completing the capsulorhexis to stabilize the capsular bag for phacoemulsification and cortical removal.
Neither iridodonesis nor phacodonesis
As a result, postoperative pseudo phacodonesis
can lead to pigment dispersion and chronic inflammation.2
Anterior chamber (AC) migration of intravitreal gas is a potential complication, which might occur even in phakic eyes with no significant zonular dehiscence or phacodonesis
(3,4,5,6,7,8) Previous studies showed that zonular weakness with subsequent phacodonesis
in PEX syndrome could lead to anterior lens movement, increased lens thickness (LT) and shallow anterior chamber.
Myopia and a vibration of the crystalline lens on eye movement (phacodonesis
) can occur prior to subluxation.
There may be no clinical signs in the anterior segment, although a history of ocular trauma may be corroborated by pupillary sphincter ruptures, lens subluxation, or phacodonesis
. In people with diabetes, and those with suspected previous vascular occlusion, you should examine the iris carefully for evidence of rubeosis iridis prior to dilatation of the pupil.
(22) It may be indicated by the presence of a subluxated lens, phacodonesis
(increased mobility of the lens) or iridodonesis (increased mobility or tremulousness of the iris).