First Author: M.Grozdeva BULGARIA
Co Author(s):
Purpose:
Presesntation of a difficult case for cataract surgery in a 27 years old woman with aniridia of her right eye, with brachytherapy, done in her childhood and enucleation of the left eye.
Setting:
: St. Petka Eye Clinic, Varna, Bulgaria
Methods:
• Patient J. Tcv., 27 years old woman
• Main complaint: Gradual decrease of visual acuity for period of 1-2 years, increased glare, decreased contrast sensitivity.
Past medical history:
• Heritable, trilateral retinoblastoma, diagnosed at 2 years old age. It was done enucleation of the left eye and brachytherapy of the right eye.
Ophthalmologic examination:
• Right eye visual acuity = counting fingers from 30 cm.
• Left eye = abulbia
• RE IOP= 8.2 mm Hg
• Anterior Segment – anirirdia, cortical and posterior subcapsular cataract.
• Posterior segment – dome shaped, white-gray, irregular lesion, engaging posterior pole.
Results:
Our approach:
Preoperative measurements: refraction, biometry, slit-lamp exam, ophthalmoscopy, patient preparation.
The operation was done under general anesthesia.
Scleral tunnel incision was made, capsulorhexis, hydrodelineation. Chopping technique was used and less vacuum and less flow in irrigation aspiration. We chose to implant three piece IOL, because we suspected zonular weakness, insufficient zonular or capsular support and also irregular fibrosis of the sac after the brachytherapy.
Right eye visual acuity after surgery=0.3
Slit lamp exam – IOL, stable situated in the bag
Conclusions:
If there are factors that determine capsular bag weakness and postoperative fibrosis is unclear better surgical technique is as gentle without a stretch of zonules. Intraocular lens should be chosen so as to ensure stable positioning in the capsular bag with minimal potential postoperative dislocation.
Financial Disclosure:
None
