Adapting Optic Capture For The Treatment Of Microspherophakia With Ectopia Lentis Using A 3-Piece Iol
Published 2025 - 43rd Congress of the ESCRS
Reference: PO029 | Type: Case Report | DOI: 10.82333/6988-7a55
Authors: Călin Petru Tătaru* 1 , Cătălina Ioana Tătaru 2 , Paul Filip Curcă 3 , Cristina Cojan 4 , Maria Halici 4
1Department of Ophthalmology, Central Military Emergency Hospital Dr. Carol Davila,Carol Davila University of Medicine and Pharmacy,Bucharest,Romania;Ophthalmology Compartment I,Clinical Hospital for Ophthalmological Emergencies,Bucharest,Romania;Ophthalmology,Alcor Clinic,Bucharest,Romania, 2Ophthalmology Compartment I,Clinical Hospital for Ophthalmological Emergencies,Bucharest,Romania;Ophthalmology,Alcor Clinic,Bucharest,Romania;Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies,Carol Davila University of Medicine and Pharmacy,Bucharest,Romania, 3Department of Ophthalmology, Central Military Emergency Hospital Dr. Carol Davila,Carol Davila University of Medicine and Pharmacy,Bucharest,Romania, 4Ophthalmology Compartment I,Clinical Hospital for Ophthalmological Emergencies,Bucharest,Romania
Purpose
Microspherophakia poses challenges in the surgery of paediatric cataract due to alterations on the lens bag size, zonular system and increased anteroposterior lens diameter. We describe a case where due to small lens bag size and zonular rigidity we adapted the optic capture technique using a 3-piece IOL to anterior rhexis optic capture and sulcus haptic placement.
Setting
Retrospective case report.
Report of case
A 7-year-old paediatric patient presents with bilateral decreased visual acuity due to microspherofakia and mild ectopia lentis. Visual acuity measured 0.2 decimal 20/100 bilaterally using spherical and cylinder correction (OD -7.5 / -1.5 21, OS -7 / 1.75 152). We performed surgery on the right eye and planned for the use of a 22 diopter 3-piece IOL for +1.57 D spherical target. Intraoperatively the small lens bag presented zonular rigidity. We enlarged the anterior capsulorhexis and evaluated IOL placement options. Due to lesser bag size and zonular rigidity we chose to proceed with optic capture of the 3-piece IOL with the optic behind the anterior capsule and sulcus haptic placement; thus offering stability in lieu of the microspherophakia lens bag. Postoperatively IOL position was well centered and visual result satisfactory.
Conclusion/Take home message
The challenges posed by a microspherophakia lens bag can be adapted to using a 3-piece IOL and performing optic capture where the optic is placed behind at least the anterior capsule, if possible the posterior too, and the haptics are sulcus placed and thus not subject to small lens bag or zonular limitations. This technique adapts a readily available 3-piece IOLs to microspherophakia intraoperative conditions.