Congenital coloboma and cataract: clinical evaluation and surgical outcomes

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Monday 09/10/2017 | 14:30-16:00

Paper Time: 15:36

Venue: Meeting Center Room I

First Author: : J.Soundarapandian INDIA

Co Author(s): :    S. Karuppasamy   N. Madhivanan                 

Abstract Details

Purpose:

To determine the preoperative challenges and evaluate the efficacy and safety of cataract extraction with IOL implantation in eyes with congenital coloboma and cataract

Setting:

This prospective Descriptive analysis study, carried out for a period of 9 months (August 2015 – April 2016),at Cataract and IOL service of K.S. Eye Care, India , comprised of consecutive series of patients with typical congenital iris coloboma who had surgery for age related cataract.

Methods:

75 eyes of 71 patients were enrolled. Depending on the Corneal diameter,anterior chamber depth,zonular integrity and grade of cataract either a planned cataract extraction alone (3 eyes) or extracapsular cataract extraction (8 eyes) or small incision cataract surgery (53 eyes) or phacoemulsification with PCIOL implantation (11 eyes) was performed. Surgical steps were customized for every eye to prevent complication. CTR is inserted to re-establish the capsular contour and stability in lens coloboma. Patients were reviewed at first and third month. Data collection and analysis was done by measurement of parameters using observational check list.

Results:

Mean age of patients was 45 years. Microcornea was noted in 24 eyes (32%). 67 eyes(89.3%) had standard sized PCIOL implantated in the capsular bag. 11 eyes had CTR. No postoperative complications were noted in our study. Improvement in Visual acuity was noted in 70 eyes (93.3%). 5 eyes(6.7%) had no change in visual acuity. None had drop in visual acuity. 24 eyes (32 %) having a postoperative corrected acuity of worse than 6/36 correlated with preoperative retinochoroidal coloboma involving optic disc and macula. All patients postoperatively had well centered and stable PCIOL.

Conclusions:

1. Cataract in eyes with coloboma tends to occur at an earlier age than in eyes with typical visually significant age related cataract. 2. Although cataract surgery in eyes with congenital coloboma and cataract can present preoperative and technical intraoperative challenges, our study suggests, that with complete preoperative evaluation and perfectly preplanned right surgical technique it is safe to perform cataract surgery in coloboma eyes and provide consistently good outcome, all the time.

Financial Disclosure:

NONE