Traumatic anterior capsule rupture in a patient with Alport syndrome without anterior lenticonus

Introduction: To report a rare case of traumatic anterior lens capsule rupture in a patient with Alport syndrome (AS) occurring in the absence of anterior lenticonus, and to highlight the clinical course, imaging findings, and surgical considerations associated with the inherent anterior capsule fragility of AS. Case Report: A 24-year-old male with AS presented after blunt ocular trauma with glare and reduced vision in the right eye. Examination revealed an isolated anterior lens capsule defect without cataract formation or anterior lenticonus. Over short-term follow-up, the defect progressed with early cataract formation and anterior nuclear protrusion confirmed on anterior segment optical coherence tomography. The patient underwent femtosecond laser-assisted capsulotomy and phacoemulsification with toric posterior-chamber intraocular lens implantation (PCIOL). Surgery was uneventful, and postoperative visual acuity and visual quality improved with resolution of glare. Conclusion: Patients with AS possess intrinsically fragile anterior lens capsules due to type IV collagen defects and may develop anterior capsule rupture even without anterior lenticonus. Blunt trauma can precipitate isolated capsule dehiscence with minimal initial cataract formation, Femtosecond laser-assisted capsulotomy may offer enhanced safety in these patients by reducing the risk of capsular extension during surgery.