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Cataract surgery in eyes with congenital ocular coloboma

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Abstract

Purpose

To assess the safety, efficacy, and complication rate of phacoemulsification and intraocular lens (IOL) implantation in patients with congenital uveal coloboma and to evaluate the role of pupilloplasty.

Methods

A retrospective review of 41 eyes (31 patients) with congenital coloboma that underwent phacoemulsification and IOL implantation between September 2012 and September 2018. Preoperative, intraoperative, and postoperative data were collected for analysis.

Results

The mean patient age at surgery was 53.9 years (range 15–82). The primary indication for surgery was cataract removal for visual improvement, and lens subluxation was additionally present in two eyes (5%) preoperatively. The mean preoperative corrected distance visual acuity (CDVA) was 0.90 LogMAR. Phacoemulsification surgery was performed in all cases and nine eyes (22%) had pupilloplasty for pupil reconstitution at the time of the procedure. Surgeon grade varied from trainee surgeon under supervision to consultant. Eight patients (19.5%) had posterior capsular rupture (PCR) with or without vitreous loss requiring anterior vitrectomy. Of these, 2 cases (5%) had dropped nuclear fragments requiring subsequent pars plana vitrectomy and lens fragment removal. The mean postoperative CDVA was 0.62 LogMAR (p = 0.0003).

Conclusion

Patients with iridolenticular choroidal coloboma appear to be more at risk of complications, as were cases performed by non-consultant surgeons. Contrary, patients with phakodonesis, preoperative anterior chamber vitreous, dense cataracts, and cases were iris hooks used had no significant difference at PCR rate. The risk of postoperative glare and pupilloplasty needs to be considered in cases with good visual potential to avoid a possible second procedure.

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Abbreviations

IOL:

Intraocular lens

AC:

Anterior chamber

PCR:

Posterior capsule rupture

PCO:

Posterior capsule opacification

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Funding

This study was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology.

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Authors and Affiliations

  1. Cataract Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom

    Maria Phylactou, Francesco Matarazzo, Alexander Clifford Day, Badrul Hussain & Vincenzo Maurino

  2. Cornea and External Diseases Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom

    Maria Phylactou, Alexander Clifford Day & Vincenzo Maurino

  3. NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust , London, United Kingdom

    Alexander Clifford Day

  4. Institute of Ophthalmology , University College London , London, United Kingdom

    Alexander Clifford Day

Authors
  1. Maria Phylactou
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  2. Francesco Matarazzo
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  3. Alexander Clifford Day
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  4. Badrul Hussain
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  5. Vincenzo Maurino
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Corresponding author

Correspondence to Maria Phylactou.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Moorfields Eye Hospital NHS Foundation Trust, London (reference: CA18/CT/04-154) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Phylactou, M., Matarazzo, F., Day, A.C. et al. Cataract surgery in eyes with congenital ocular coloboma. Graefes Arch Clin Exp Ophthalmol 258, 2753–2759 (2020). https://doi.org/10.1007/s00417-020-04915-1

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  • DOI: https://doi.org/10.1007/s00417-020-04915-1

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