Lens subluxation with vitreous (Video)

This video shows a cataract lens that has dislocated backwards after blunt trauma. You can even see a veil of vitreous coming around the lens into the anterior chamber. This cataract will be difficult to remove, as an anterior approach is unsafe (there is too much zonular dehiscence such that the lens might fall into the back of the vitreous). Instead, it was removed by a two-step approach: a posterior lens removal by a retinal surgeon with a later anterior chamber lens placement by a cataract surgeon.

While this lens misplacement occured from trauma, other causes of lens displacement include heriditary conditions (Marfan’s syndrome, homocystinuria, hyperlysinuria sulfite oxidase deficiency, Weill-Marchesani syndrome, aniridia and Ehlers-Danlos syndrome) and from hypermature cataracts where the lens has gotten so big that the zonular support springs are lost.