Dr. Sonal Gupta, Dr. Alok Sen, Dr. Ashish Mitra, Dr. Shubhi Tripathi
Purpose: Cataract surgery in microcornea and coloboma possess several challenges. Most of them are young, one eyed having ambulatory vision before development of cataract having small anterior segment with normal or long posterior segment. The normal sized nucleus in small anterior chamber makes removal of hard cataract through limbal route difficult but also fraught with complications like endothelial damage, vitreous loss and suprachoroidal hemorrhage. More so in severe microcornea (corneal diameter ≤ 7mm) and very hard cataract (nuclear sclerosis grade 5).
Methods: 21 Cases of hard cataract with severe microcornea and choroidal coloboma managed through pars plana approach. Dislocating the nucleus posteriorly, thorough vitrectomy was done followed by fragmentation of nucleus.
Results: Significant visual improvement seen in 70% of cases and 10% had complications like retinal detachment.
Conclusion: Safest approach and recommended only in eyes with severe microcornea with hard cataract.