Posters

Cataract surgery in colobomatous eyes: a case series

Poster Details

First Author: S. Talwar INDIA

Co Author(s):    N. Koladiya   P. Sen   A. Sethi              

Abstract Details

Purpose:

To analyse and present the surgical challenges associated with cataract surgery in colobomatous eyes. There are no clear guidelines as to the management of cataracts in colobomatous eyes especially with microcornea and microophthalmos.The paper aims to discuss the difficulties in operating on these eyes.

Setting:

A well documented case series of 15 patients with cataract in colobomatous eyes operated by a single surgeon at a tertiary referral hospital in India.

Methods:

A Retrospective chart analysis. Fifteen cataract surgeries in colobomatous eyes with and without microcornea and nystagmus in all grades of nuclear sclerosis done by the presenting author in 1 year were analysed .Eight cases were video recorded.

Results:

Out of 15 eyes, 11 eyes underwent phacoemulsification with (10 eyes) and without (1 eye) intraocular lens (IOL) implantation in the bag ,3 eyes underwent extracapsular cataract extraction (ECCE) with (2 eyes) and without (1 eye) IOL implantation in the sulcus.In one eye the phacoemulsification procedure was attempted but was converted to lensectomy with vitrectomy (L+V) done by a vitreoretinal surgeon.Three eyes had microcornea (range 8.1 - 10.5 mm) .Out of three eyes with microcornea 2 eyes underwent ECCE with (1 eye) and without (1 eye) IOL implantation , in one eye ,the phacoemulsification was converted to L+V procedure.

Conclusions:

The density of cataract decides the choice of surgery ,phacoemulsification for the soft cataract (grades 1,2,3) and conventional extracapsular cataract extraction for the very hard cataract (grade 4 and above).The cataract appears deceptively soft on the slit lamp evaluation than what is experienced during the surgery on table.The inferior zonular weakness can be managed with a capsular tension ring.The authors recommend a posterior approach (L+V) for eyes with a horizontal white to white diameter of less than 8 mm.

Financial Disclosure:

NONE