Successful Cataract Surgery and Iridoplasty in Patient With Megalocornea
Narrative Responses:
Purpose
To describe an unusual case with megalocorneas who underwent cataract surgery and iridoplasty.
Methods
41 years old man presented to our clinic with low vision. Ocular examination showed presence of bilateral posterior subcapsular cataracts, bilateral megalocornea, iridodonesis, an undeveloped rudimentary iris and phacodonesis. Corrected visual acuity was 20/100 in the left eye. The diameter of cornea was extremely wide in both eyes (22mm). Due to large capsular bag, standard posterior chamber intraocular lens could not be implanted. First, we performed phacoemulsification in the left eye, then pupil cerclage was performed and afterwards we implanted an aspheric scleral fixation intraocular lens in the posterior chamber, also this lens was fixated to the iris.
Results
The standard phacoemulsification instruments were too small for him, so we had to use microforceps and microscissors during surgery. 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.
Conclusion
Cataract surgery in megalocornea is challenging and ocular hypotony may be observed especially in the cases where iris is manipulated.