Cataract surgery in eyes with associated coloboma: Predictors of outcome and safety of different surgical techniques
Open Access
- 1 January 2021
- journal article
- research article
- Published by Medknow in Indian Journal of Ophthalmology
- Vol. 69 (4), 937-945
- https://doi.org/10.4103/ijo.ijo_2276_20
Abstract
Purpose: The aim of this study was to report the outcome of cataract surgery with different surgical techniques in eyes with coexisting coloboma and to define factors of prognostic importance. Methods: Retrospective case sheet review of patients presenting between January 2016 and December 2018, who underwent cataract surgery in eyes with coexisting coloboma. Results: Of the 3,30,231 cases operated during the study period, 280 eyes of 276 patients had associated colobomatous malformation. The prevalence of coloboma in eyes undergoing cataract surgery was 0.085%. The mean age of the patients was 46.4 years (range 19 - 88 years). Phacoemulsification (PE) was performed in 130 eyes (46.4%), manual small incision cataract surgery (M-SICS) was done in 115 eyes (41.1%), and 35 eyes (12.5%) underwent intra capsular cataract extraction. Intra-operative complications were noted in 26 (9%) eyes. Incidence of intra-operative and post-operative complications was comparable between PE and M-SICS groups (p = 0.94). The mean corrected distance visual acuity (CDVA) improved from logMAR 1.71 ± 0.62 to 0.87 ± 0.61 (p = 0.00009). On multivariate analysis, microcornea (p = 0.002), type 1 and 2 coloboma (p < 0.001), and intraoperative complications (p = 0.001) were associated with poor visual outcome. Conclusion: Favorable functional outcomes can be achieved with phacoemulsification in eyes with softer cataract and corneal diameter >8 mm and with M-SICS in eyes with hard cataracts and corneal diameter of 6–8 mm. PE should be considered as the primary choice whenever permissible by the corneal diameter and severity of nuclear sclerosis. Poor functional outcomes were seen in eyes with smaller corneal diameter, extensive chorioretinal coloboma, and intraoperative complications.Keywords
This publication has 16 references indexed in Scilit:
- Lenticular Changes in Congenital Iridolenticular Choroidal ColobomaAmerican Journal of Ophthalmology, 2014
- Outcomes of phacoemulsification in eyes with congenital choroidal colobomaAlbrecht von Graefes Archiv für Ophthalmologie, 2013
- Cataract surgery in eyes with congenital iridolenticular choroidal colobomaBritish Journal of Ophthalmology, 2011
- Incidence, Ocular Findings, and Systemic Associations of Ocular ColobomaJAMA Ophthalmology, 2011
- Standardization of Uveitis Nomenclature for Reporting Clinical Data. Results of the First International WorkshopAmerican Journal of Ophthalmology, 2005
- Ocular ColobomataSurvey of Ophthalmology, 2000
- The Lens Opacities Classification System IIIAmerican Journal of Ophthalmology, 1993
- Prevalence of Age-related Lens Opacities in a PopulationOphthalmology, 1992
- Long-term Corneal Endothelial Cell Loss After Cataract SurgeryAmerican Journal of Ophthalmology, 1986
- Use of a grading system in the evaluation of complications in a randomised controlled trial on cataract surgery. Oxford Cataract Treatment and Evaluation Team (OCTET).British Journal of Ophthalmology, 1986