ESCRS - CC02.02 - Cataract Surgery With Bag-In-The-Lens Intraocular Lens Implantation In Megalocornea: A Case Report

Cataract Surgery With Bag-In-The-Lens Intraocular Lens Implantation In Megalocornea: A Case Report

Published 2025 - 43rd Congress of the ESCRS

Reference: CC02.02 | Type: Case Report | DOI: 10.82333/76ar-3c46

Authors: Sabrina Vaccaro* 1 , Mariacarmela Ventura 1 , Mariantonia Ferrara 1 , Maria Laura Passaro 2 , Francesco Semeraro 1 , Sorcha Ní Dhubhghaill 3 , Vito Romano 1

1Ophthalmology,University of Brescia ,Brescia,Italy, 2Neurosciences, Reproductive Sciences and Dentistry,University of Naples "Federico II",Naples,Italy;Department of Medicine and Health Sciences "V. Tiberio",University of Molise,Campobasso,Italy, 3Ophthalmology,University Hospital Brussels,Jette,Belgium;Medicine and Pharmacology,University of Brussels,Brussels,Belgium

Purpose

To report the surgical management of cataract extraction and intraocular lens choice in patient in patients with megalocornea.

Setting

Eye Clinic, University of Brescia

 

Report of case

A 48-year-old man presented with posterior subcapsular cataract and megalocornea in the right eye at our corneal center. Given the high white-to-white measurement, the increased risk of dislocation associated with a standard implant, and the low predictability of the effect of lens position, a bag-in-lens (BIL) intraocular lens (IOL) implantation was chosen. The patient underwent to standard phacoemulsification. After breaking the central posterior capsule with a needle, a low-molecular-weight OVD was administered below the posterior capsule. This was performed in order to move the anterior hyaloid. In addition a posterior curvilinear capsulorhexis of equal dimensions to the anterior capsulorhexis was performed to facilitate the insertion of the BIL IOL (Morcher; cylinder power: 14.0 diopters (D)). The two capsules were slowly inserted into the groove of the IOL, with the anterior flange positioned above the anterior capsule. After 1 week, the uncorrected visual acuity (UCVA) was logMAR 0.0 in the right eye, IOP was 15 mmHg and the lens was correctly positioned. All remained stable in the follow up.

Conclusion/Take home message

Bag-In-The-Lens Intraocular Lens Implantation is a valid option in patients with megalocornea and cataract. We believe that BIL IOL implantation is a highly effective approach. The technical challenges involved with this procedure should not pose any difficulties for a cataract surgeon.