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Cataract surgery in a maldeveloped eye
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 Cataract in a maldeveloped eye. |
Routine cataract surgery in a normal eye can be a challenge because you never know exactly how the case will proceed. In a maldeveloped eye with unknown anatomy, cataract surgery is far more difficult and can be unpredictable. And we all know that the worst place for a surprise is intraoperatively during an elective surgery.
This patient is 50 years old and presents to you with a decrease in vision. Both eyes look the same: maldeveloped anterior segments, with an iris coloboma and micro-cornea. The white-to-white measurement is approximately 8 mm in both horizontal and vertical meridians. The cornea is somewhat irregular on topography, and the lens shows cortical opacities in the visual axis. The axial length of the eye is short at 19 mm. The posterior segment shows an inferior retinal coloboma.
Ultrasound imaging of the eye, including anterior segment UBM, is pending.
What more would you like to know before proceeding with this case? And if you've done cases like this before, please share your experiences.