Rehabilitating Colobomata : Our Experience In A Tertiary Care Center

To evaluate the pre operative and intraoperative difficulties in management of patients with
coloboma who present with cataract, and to provide the best visual rehabilitation to these patients.

Tertiary Care Hospital in Northern India 

This observational case series was done on 35 patients with colobomas who presented to us with
cataract. Different intraocular lenses were implanted according to the technical difficulties faced during surgery. Analysis
of preoperative, intraoperative findings were clubbed with post operative findings of each patient.

No patient was left aphakic. All patients with coexisting fundal colobomas were first given barrage laser
sessions before surgery for scleral fixated IOL, and after surgery for in the bag PCIOL. No patient developed retinal or
choroidal detachment. Among secondary IOLs, 3 piece PMMA IOLs performed the best, iris claw IOL was implanted in 4
patients, all 4 patients had anterior chamber reaction. Hydrophilic acryllic single piece IOLs inserted as SFIOL also
experienced mild anterior chamber reaction but good post operative vision gain.

The best option we documented is to stabilise the bag with lack of zonules by use of a
capsular tension ring or segment and place a posterior chamber IOL, however when a secondary IOL is needed the best
outcome was seen with a 3 piece PMMA optic SFIOL with Hoffmann pockets. Cataract surgery is in adjunct with
management of retinal colobomata, wherein our treatment options range from a simple barrage laser to low vision aids.