Posters

A case of a customized Artisan® Aphakia implantation in a microanterior segment with dense cataract and inferior coloboma. Two-stage surgical planning

Poster Details

First Author: M.Royo Sans SPAIN

Co Author(s):    A. Jiménez López                    

Abstract Details

Purpose:

Optical and surgical management of the cataract surgery in a microanterior segment patient with an inferior coloboma.

Setting:

Department of Ophthalmology, Hospital San Rafael, Madrid, Spain.

Methods:

A 44-year-old patient, was consulted to our ophthalmology department due to progressive visual acuity (VA) decrease. The corrected VA before surgery was superior than 1.0 LogMar. The ophthalmological examination shows a chorectopia secondary to a lower coloboma of the iris, zonula and retina, and a dense cataract. The anterior chamber was 0.89 mm and the axial length measured was 23.10 mm. Two-stage surgery were performed. In a first surgery, intracapsular cataract extraction by reverse corneo-corneal incision, iridoplasty and anterior and retropupillary vitrectomy were performed. In the second surgery was retropupillary implanted a customized Artisan® Aphakia IOL throught a scleral tunnel.

Results:

After the second surgery the biomicroscopy showed a correctly retropupilary possition of Artisan Aphakia IOL being implanted to 2.48 mm from the endothelium. The intraocular preassure (IOP) was 15mm Hg and the pupil was centered. The retina was unchanged. Uncorrected visual acuity (UNCVA) was 0.48 LogMar after surgery.

Conclusions:

Patients with iridoretinal coloboma may have lens instability due to zonal deficiency intra-surgically which suggests intracapsular surgery. Two-stage surgical planning helps the patient's appreciation of the complexity of the surgical process. The two-stage surgical approach ensures a better optic result, since it allows measuring the effective position of IOL and not estimating it with the contralateral eye.

Financial Disclosure:

None