Surgical management of bilateral congenital coloboma of the iris and congenital cataract
N.F. Bobrova , Dr Sc (Med), Prof.; D.V. Smaglii, internship doctor
SI “Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine”;
Background. A combined character of a defect, which is congenital coloboma in the presence of congenital cataract, brings up an issue of choosing optimal management to achieve the maximum possible optical functions, provided that the risk of development of operational and postoperative complications is reduced.
Purpose. To analyze a character, features, and complications and to develop the optimal surgical management of bilateral congenital iris coloboma and cataract.
Material and Methods. Visual acuity testing, standard ophthalmic examination, distance ultrasound biometry, keratometry, ultrasound scanning were performed.
Results and Conclusions. We performed minimally invasive surgery including phacoemulsification of congenital cataract with IOL endocapsule implantation and formation of optic diaphragm without interventions in the iris. Visual acuity in the pseudophakic left eye increased to 1.0 within 3 months, additional diaphragming was not able to correct visual acuity. High visual acuity, 1.0, remained in the right eye in the presence of coloboma of the iris and partial cataract. Binocular vision was achieved.
The autoplasty method using the proper lens capsule for coloboma of the iris made it possible to maximally improve visual acuity in the eyes with double congenital abnormality of the iris and the lens. The reasonable attitude to corepraxy, considering the bilateral damage, enabled to achieve binocular vision within the shortest possible period of time after surgery.
Key-words: congenital coloboma of the iris, congenital cataract, childhood, cataract phacoemulsificаtion, IOL implantation, autoplasty
- Bobrova NF, Vit VV. [Atlas of congenital and hereditary diseases of the eye]. Odessa:Palmira;2006. 140p. Russian.
- Bobrova NF. [Reconstructive surgery of the visual organ damage in children]. Odessa:Feniks;2013. 176p. Russian.
- Bobrova NF, Skripnichenko ZM. [Cataract: toxic, congenital, secondary]. Odessa:Feniks; 2010. 570p. Russian.
- Vit VV. [The structure of the human visual system]. Odessa: Astroprint; 2010. 570p. Russian
- Stashkevich SV, Shanturova MA, Malyshev VV. Oftalmohirurgiia.2006;2:15-8. Russian.
- Bermejo E, Martinez-Frias ML. Congenital eye malformation: clinical – epidemiological analysis of 1,124,654 consecutive births in Spain. Am J. Med. Genet. 1998;75:497-504.
- Duke-Elder S. System of Ophthalmology. Vol 3: Normal and Abnormal Development, Part 2: Congenital Deformities. – St Louis, CV Mosby Co, 1964: 456-481.
- Jaffe NS, Clayman HM. Cataract extraction in eyes with congenital colobomata. J. Cataract Refract.Surg. 1987;13:54-8.
- Nixseaman DH. Cataract extraction in case of congenital coloboma of the iris. Br. J. Ophtalmol. 1968;52:625-7.
- Nordlund ML, Sugar A, Moroi SE. Phacoemulsificаtion and intraocular lens placement in eye with cataract and congenital coloboma: Visual acuity and complications. J. Cataract Refract. Surg. 2000;26:1035-40.