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Big eyes big problems: successful cataract surgery and iridoplasty in a patient with megalocornea

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Session Details

Session Title: Cataract Surgery Special Cases I

Session Date/Time: Sunday 14/09/2014 | 14:30-16:30

Paper Time: 14:54

Venue: Boulevard G

First Author: : D.Dursun Altınörs TURKEY

Co Author(s): :    L. Asena              

Abstract Details

Purpose:

To report the the procedure and outcome of cataract surgery and iridoplasty in a patient with megalocornea.

Setting:

Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.

Methods:

Interventional case report.

Results:

A 41 years old man presented with low vision in both eyes. Ocular examination revealed bilateral posterior subcapsular cataracts, bilateral megalocornea, iridodonesis, an undeveloped rudimentary iris and phacodonesis. Corrected visual acuity was 30/100 in the right eye and 20/100 in the left eye. The diameter of cornea was extremely wide in both eyes (22mm). Due to a large capsular bag, a standard posterior chamber intraocular lens could not be implanted. First, we performed phacoemulsification in the left eye, then a pupil cerclage was performed and afterwards we implanted an aspheric scleral fixation intraocular +20D lens (AcrivaUD HAF, VSY) in the posterior chamber and also this lens was fixated to the iris. The optic size of the lens was 6.50mm and the haptic size was 13.75mm. The standard phacoemulsification instruments were too small for him, so we had to use microforceps and microscissors during surgery. The IOL refractive power was calculated with IOL Master and with standard contact ultrasound biometry. Postoperatively the intraocular lens was well centered and the visual outcome was good but 2 days later the patient developed choroidal detachment due to hypotony which resolved in 8 days’ time. He did well during the rest of the follow up.

Conclusions:

Cataract surgery in megalocornea is challenging and ocular hypotony may be observed especially in the cases where iris is manipulated.

Financial Interest:

NONE

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