1. Couching of cataractous lens in microphthalmic eyes with irido-fundal coloboma: revisiting the historical technique.
- Author
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Kannan NB, Goswami A, Vallinayagam M, and Sarkar AD
- Subjects
- Humans, Retrospective Studies, Female, Male, Middle Aged, Adult, Iris surgery, Iris abnormalities, Lens Implantation, Intraocular methods, Cataract Extraction methods, Lens, Crystalline abnormalities, Lens, Crystalline surgery, Follow-Up Studies, Coloboma diagnosis, Coloboma complications, Coloboma surgery, Microphthalmos complications, Microphthalmos diagnosis, Microphthalmos surgery, Visual Acuity, Cataract complications, Cataract congenital, Cataract diagnosis
- Abstract
Purpose: Cataract surgery in microphthalmic eyes is challenging due to anatomical restraints, hard bulky nucleus. This series aims to evaluate the safety and efficacy of couching of intraocular lens in irido-fundal coloboma with microphthalmos., Setting: Tertiary care centre in South India., Design: Retrospective non-comparative study in eyes with irido-fundal coloboma, corneal diameter < 7 mm and brown cataract. Visual acuity less than 6/60 in other eye., Methods: Anterior chamber entry made, zonules broken and lens dislocated into the vitreous cavity in a controlled manner. Baseline Clinico-demographic details, corrected distance visual acuity (CDVA), Intra-ocular pressure (IOP), corneal diameter, axial length, lens status and post-surgery CDVA, IOP and complications recorded and followed up for atleast 6 months., Results: Fifteen eyes of 15 subjects were evaluated with a mean age 49.4 ± 10.9 years. At baseline, mean IOP 14.5 ± 3.8 mmHg, mean axial length 19.3 ± 0.5 mm, mean corneal diameter was 6.5 ± 0.34 mm and CDVA 2 logMAR which improved to 1.5 logMAR at 3 months (p value 0.002). Transient spike in IOP in 33.3% subjects was medically managed with no significant difference in IOP (p > 0.05) at baseline (14.5 ± 3.8 mmHg), 3 months post-surgery (16 ± 2.8 mmHg) and 6 months post-surgery (14.9 ± 2.5 mmHg). One patient underwent re-couching. No other major complications were noted., Conclusion: Couching of cataractous lens is an effective and safe method in microphthalmic eyes with irido-fundal coloboma as last resort procedure, where no other surgical procedure may work. It provides an ambulatory gain of visual acuity in previously non-ambulatory subjects. Corneal measurements help in determining the subset of patients where couching offers viable option., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
- Published
- 2024
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