Unilateral anteroposterior sutural cataract revealing asymptomatic hypoparathyroidism

¹Cadi Ayyad University, Ophthalmology Department, Med VI University Hospital, Avicenne Military Hospital, Marrakech, Morocco

^&Corresponding author
El Filali El Mehdi, Cadi Ayyad University, Ophthalmology Department, Med VI University Hospital, Avicenne Military Hospital, Marrakech, Morocco

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Cataracts are both the first surgical etiology and the leading cause of curable blindness in ophthalmology. Various types of cataracts have been described, depending on their stage and anatomical location in the lens. Sutural cataract is a very rare presentation of crystalline opacification. We report the case of a 39-year-old woman, with no ophthalmological or general history, who presented with a moderate drop in visual acuity associated with a sensation of glare. Ophthalmological examination revealed corrected visual acuity of 5/10 in the right eye and 10/10 in the left, and an anteroposterior sutural cataract in the right eye, whereas the fundus showed no abnormalities. The diagnoses of congenital cataract, minimal post-traumatic, and secondary cataract were evoked and the patient was referred to internal medicine for an etiological work-up. Phosphocalcic assessment, parathyroid hormone, and 25-hydroxy-vitamin levels revealed hypoparathyroidism with slight hypocalcemia and normal phosphatemia, and the diagnosis of cataract secondary to hypoparathyroidism was retained. A sutural cataract is defined by the opacification of the two sutures of the embryonic crystalline nucleus, in the shape of an anterior "straight Y" (A) and a posterior "inverted incomplete Y" (B). After 3 months, the patient underwent phacoemulsification cataract surgery with complete restoration of her visual acuity and disappearance of visual blur.

Figure 1: Y-shaped lenticular opacities which followed the Y sutures of foetal lens nucleus: A) anterior lens opacity was in the form of “upright Y”; B) posterior lens opacity was “ inverted Y” shaped