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Late spontaneous bilateral intraocular lens subluxation accompanied with intraocular pressure elevation in a patient with acromegaly

1 Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan; School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
2 Department of Ophthalmology, Changhua Christian Hospital, Changhua; School of Medicine, Chung-Shan Medical University, Taichung; School of Medicine, Kaohsiung Medical University, Kaohsiung; Department of Optometry, Da-Yeh University, Changhua, Taiwan

Correspondence Address:
San-Ni Chen,
Department of Ophthalmology, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua 500
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_76_19

A 53-year-old male with newly diagnosed acromegaly came to our clinic with the chief complaint of diplopia. He had the past ocular history of uneventful phacoemulsification cataract surgery with intraocular lens (IOL) implantation in the right eye 17 years ago and left eye 15 years ago. Postoperative examination showed remarkable improvement in visual acuity. Two years ago, he developed elevated intraocular pressure (IOP) in both eyes, which was well-controlled with the use of travoprost 0.004%/timolol 0.5%. At the clinic, slit-lamp examination revealed inferiorly subluxated IOL bilaterally. The patient received IOL repositioning with pars plana vitrectomy and scleral fixation in the left eye smoothly. We hypothesize that excess growth hormone is associated with dysregulation of fibrillin, resulting in zonular weakness, which causes late bilateral IOL subluxation. Elevated IOP may also be related to acromegaly. To the best of our knowledge, this is the first report to describe the association between IOL subluxation and acromegaly.

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