Abstract：
BACKGROUND: Eyes with a short axial length or anterior chamber depth often develop narrowed anterior chamber angles in association with an enlarging crystalline lens. We report a case of a patient who presented in angle closure, with a distant history of prior intervention for congenital cataracts and was presumed to be aphakic.
METHODS: A 78-year-old male presented with acute onset unilateral eye pain and blurred vision. He was found to have increased intraocular pressure, anteriorly bowed iris, and angle closure. Despite prior documentation of aphakia after treatment for congenital cataracts, detailed workup revealed residual crystalline lens material pushing the peripheral iris anteriorly. Further history confirmed that the patient underwent a procedure in the 1940\'s to remove lens material centrally but was not truly aphakic. The patient was treated with anterior chamber paracentesis and intraocular pressure lowering drops. His intraocular pressure remains controlled with medical therapy alone.
CONCLUSIONS: Patients that appear to be aphakic centrally may still present with angle closure secondary to residual peripheral lens material. This case highlights the importance of keeping this etiology on the differential in a patient with presumed aphakia.
METHODS: A 78-year-old male presented with acute onset unilateral eye pain and blurred vision. He was found to have increased intraocular pressure, anteriorly bowed iris, and angle closure. Despite prior documentation of aphakia after treatment for congenital cataracts, detailed workup revealed residual crystalline lens material pushing the peripheral iris anteriorly. Further history confirmed that the patient underwent a procedure in the 1940\'s to remove lens material centrally but was not truly aphakic. The patient was treated with anterior chamber paracentesis and intraocular pressure lowering drops. His intraocular pressure remains controlled with medical therapy alone.
CONCLUSIONS: Patients that appear to be aphakic centrally may still present with angle closure secondary to residual peripheral lens material. This case highlights the importance of keeping this etiology on the differential in a patient with presumed aphakia.
摘要：
背景：眼轴长度或前房深度较短的眼睛通常会形成与晶状体扩大相关的前房角变窄。我们报告了一个病人出现在闭角，既往有先天性白内障干预史，推测为无晶状体。
方法：一名78岁男性，表现为急性发作的单侧眼痛和视力模糊。他被发现眼压升高，虹膜前部弯曲，和角度闭合。尽管先前记载了先天性白内障治疗后的无晶状体，详细的检查显示残留的晶状体材料向前推动周边虹膜。进一步的病史证实，该患者在1940年代接受了手术以从中央去除晶状体材料，但并非真正的无晶状体。患者接受前房穿刺术和降眼压滴剂治疗。他的眼内压仍然通过单独的药物治疗得到控制。
结论：出现中央无晶状体的患者可能仍存在继发于周边晶状体材料残留的闭角。该病例强调了在假定无晶状体眼患者中保持这种病因差异的重要性。
方法：一名78岁男性，表现为急性发作的单侧眼痛和视力模糊。他被发现眼压升高，虹膜前部弯曲，和角度闭合。尽管先前记载了先天性白内障治疗后的无晶状体，详细的检查显示残留的晶状体材料向前推动周边虹膜。进一步的病史证实，该患者在1940年代接受了手术以从中央去除晶状体材料，但并非真正的无晶状体。患者接受前房穿刺术和降眼压滴剂治疗。他的眼内压仍然通过单独的药物治疗得到控制。
结论：出现中央无晶状体的患者可能仍存在继发于周边晶状体材料残留的闭角。该病例强调了在假定无晶状体眼患者中保持这种病因差异的重要性。
