Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma.

Abstract

Introduction: Cataract may cause severe visual impairment in eyes with microphthalmos and uveal coloboma. Despite their similarities, distinguishing between these conditions is crucial for cataract surgery. We aimed to compare complications, nucleus hardness, surgical strategies, and outcomes of cataract surgery between microphthalmos and uveal coloboma.

Methods: This retrospective comparative study included 19 eyes with microphthalmos and 20 with uveal coloboma. Preoperative, intraoperative, and postoperative data of eyes that underwent cataract surgery were analysed.

Results: MO eyes had lower high-hardness nucleus rates (P=0.002) than UC. The most common preoperative complications in the microphthalmos and uveal coloboma groups were glaucoma (37.5%) and retinal detachment (15.4%), respectively. No significant differences in the phacoemulsification (P=0.45) or intraocular lens implantation (P>0.99) rates between the two groups. Extracapsular cataract extraction was performed in five eyes (25%), and posterior capsular rupture was the most common surgical complication (15%) in the uveal coloboma group. Combined surgery was mainly used to deal with high or unstable intraocular pressure (77%) in the microphthalmos group versus posterior pars plana vitrectomy (85.71%) in the uveal coloboma group to treat vitreoretinal pathologies. Corrected distance visual acuity was significantly improved in both microphthalmos (P=0.0005) and uveal coloboma (P<0.001) groups, while intraocular pressure was decreased (P=0.03) in the microphthalmos group.

Conclusion: Eyes with microphthalmos and uveal coloboma exhibited distinct cataract grades and complications, necessitating varied surgical strategies; while cataract surgery has proven to be effective in improving the visual acuity in both groups. Our findings hold significant value for guiding clinical treatment decision-making.