J Korean Ophthalmol Soc.  2013 Jan;54(1):165-169. 10.3341/jkos.2013.54.1.165.

Cataract Extraction and Intraocular Lens Implantation in Megalocornea

• Ahn SM
• Park HJ
• Lee SJ
• Park JM

• KMID: 2216467
• DOI: http://doi.org/10.3341/jkos.2013.54.1.165

Abstract

PURPOSE
To report a case that underwent successful centration of intraocular lens (IOL) and visual acuity improvement after cataract extraction in a megalocornic eye in our medical center.
CASE SUMMARY
A 27-year-old man with bilateral megalocorneas came to our medical center. The patient had progressive loss of vision and floaters in both eyes for 3 months. His horizontal corneal diameter was approximately 14 mm in both eyes. The initial best corrected visual acuity was 0.02 in the right eye and 0.5 in the left eye. There was a white cataract and nuclear sclerotic cataract without lens luxation, respectively. The cataract was extracted from the patient's right eye after anterior continuous curvilinear capsulorrhexis (CCC), the preloaded custom IOL was inserted in the bag, and pars plana vitrectomy was performed. Two months later, after the cataract was extracted from the left eye, optic capture through a posterior capsule was attempted but converted to anterior capsule (reverse optic capture) because of the posterior CCC's radial tear, and pars plana vitrectomy performed. The IOL had a 6 mm optic and an overall length of 12.5 mm. The IOL in the right eye was decentrated inferiorly in the bag due to a large capsule diameter, but the IOL captured through the anterior capsule in the left eye had good centration. The best corrected visual acuity of both eyes improved to 0.8 without other complications.

Keyword

Anterior megalophthalmos; Intraocular lens centration; Megalocornea; Optic capture

MeSH Terms

Adult
Capsulorhexis
Cataract
Cataract Extraction*
Humans
Lens Implantation, Intraocular*
Lenses, Intraocular
Patient Rights
Visual Acuity
Vitrectomy

Figure

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  Figure 1. Slit lamp photographs showing patient's megalocornea. His horizontal corneal diameter was about 14 mm in both eyes. (A) The right eye. (B) The left eye.

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  Figure 2. Slit lamp photographs showing the corneal vertical, horizontal or oblique striae. (A) The right eye. (B) The left eye.

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  Figure 3. Slit lamp photograph of the right eye 1 month postoperatively. The intraocular lens was decentrated inferiorly in the bag.

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  Figure 4. The postoperative slit lamp photographs of the left eye. (A) Postoperative 1 month. Note the vertically enlarged posterior continuous curvilinear capsulorrhexis (CCC) line (arrowhead) and the cat's eye-like anterior CCC margin (arrows) with stable optic capture state. (B) Postoperative 5 months. The intraocular lens remained well centered without pseudophacodonesis.

Reference

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