Unilateral lifebuoy cataract: A case report

Abstract

Rationale: Lifebuoy cataract is a rare congenital condition characterized by lens thinning. Due to its rarity, detailed treatment reports and standardized surgical approaches are limited. This study aims to enhance the current body of knowledge by presenting comprehensive case reports and describing surgical techniques for the treatment of lifebuoy cataracts. Patient concerns: A 14-year-old boy was diagnosed with a congenital cataract in his right eye at the age of 9, which was left untreated. The patient visited our hospital due to progressive visual impairment. Diagnoses: The visual acuity of the right eye was counting fingers at 30 cm. The uncorrected visual acuity of the left eye was 20/100, whereas the best corrected visual acuity was 20/20. The intraocular pressures were 18 mm Hg (left eye) and 20 mm Hg (right eye). Slit-lamp microscopy revealed central calcification of the lens capsule in the right eye and slightly opaque cortical tissue in the periphery, with no observable lens nucleus. Anterior segment optical coherence tomography (CASIA2, TOMEY, Nagoya, Japan) of the right eye showed fused anterior and posterior capsules and an absence of the lens nucleus, leading to a diagnosis of lifebuoy cataract. Interventions: Cataract surgery was performed on the right eye. Following a 2.4-mm sclerocorneal incision and trypan blue staining, continuous curvilinear capsulorrhexis was performed around the central opacity. The surrounding cortex was removed using irrigation and aspiration, while a viscoelastic agent was injected between the central calcified membrane and the posterior capsule. The membranous tissue was carefully peeled away and removed using forceps. Despite residual posterior capsular opacification, posterior capsulotomy was not performed due to concerns about vitreous prolapse. The intraocular lens was fixed within the capsule. Ten days post-surgery, the remaining posterior capsular opacification was treated with neodymium-doped yttrium aluminum garnet laser capsulotomy. Outcomes: The uncorrected visual acuity and best corrected visual acuity of the right eye improved to 20/100 and 20/50, respectively. Lessons: This case report demonstrates a successful surgical approach for a lifebuoy cataract, highlighting its unique morphology and the need for careful, specialized techniques. These findings aim to guide ophthalmologists in managing this rare condition, potentially improving patient care.