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Microphthalmos, cataract surgery and cystoid macular edema

Poster Details

First Author: F.Dolz-Güerri SPAIN

Co Author(s):    A. Martinez-Palmer                    

Abstract Details

Purpose:

Microphthalmos is an uncommon congenital anomaly consisting in an eyeball of short axial length, usually less than 20 mm. Microphthalmos can be unilateral or bilateral. The surgical risk and complication rate after cataract surgery are extremely high in patients with microphthalmos. Pseudophakic cystoid macular edema (CME), also known as Irvine-Gass syndrome, is one of the most common causes of visual loss after cataract surgery. There is no standardized treatment or prophylactic protocol for pseudophakic CME due to a lack of strong evidence.

Setting:

Department of Ophthalmology. Hospital de l’Esperança and Hospital del Mar – Parc de Salut Mar (Barcelona)

Methods:

The records of two patients with microphthalmos who had bilateral consecutive cataract extraction by phacoemulsification with posterior chamber intraocular lens (IOL) implantation were reviewed. Operations were performed by the same ophthalmic surgeon and the mean interval between cataract surgeries in the same patient was 1 month. IOL power calculation was obtained with Haigis formula.

Results:

Management of cataract surgery of 4 eyes of 2 patients with microphthalmos is described. Expulsive hemorrhage occurred in one eye during the surgical act. During follow-up this eye suffered an anteversion of IOL-capsular sac complex, inducing a postoperative astigmatism. Cataract surgery permitted to control intraocular pressure in one patient. Unilateral CME developed in one patient one year after cataract surgery whereas in the other patient CME appeared in bilaterally 2 years after cataract surgery.

Conclusions:

Cataract surgery requires special concerns in patients with microphthalmos. Over time, cystoid macular edema management can develop and compromise patients' vision.

Financial Disclosure:

NONE

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