Striking case of Weil–Marchesani syndrome with an extremely thick cornea

A 41-year-old male presented with diminution of vision in both eyes since the past 3 months. He was a high myope with a refractive error of -16D and -19D, best corrected visual acuities of 6/24 and 6/60, intraocular pressures measured with Goldmann applanation tonometry of 28 and 32 mmHg, and central corneal thicknesses of 711 and 734 microns in the right and left eyes, respectively. The patient had short stature and brachydactyly. Slit-lamp examination revealed clear cornea, irregular anterior chamber depth, and immature cataract in both eyes. Gonioscopy showed open angles in both eyes. On dilated anterior segment examination, lens equator could be appreciated super-temporally in the right eye and superiorly in the left eye. Fundus examination was normal except for tortuous blood vessels. He was diagnosed as a case of Weil Marchesani syndrome and was advised cataract surgery. Peroperatively, the equatorial diameter of the lens was appreciated to be less than normal. The patient underwent cataract removal with iris claw implantation due to severe zonular weakness.