We report a patient who presented with anterior megalophthalmos: corneal diameter of nearly 170 mm, anterior chamber depth of 70 mm, mild lens subluxation, and nuclear sclerotic cataract Surgical management consisted of a scleral tunnel incision, capsule staining, a predetermined capsulorhexis size, microcoaxial phacoemulsification with torsional ultrasound, and implantation of a custom IOL to ensure endocapsular fixation Special consideration must be given to the patient with a very large anterior segment

Cataract surgery and anterior megalophthalmos: Custom intraocular lens and special considerations

This report describes the implantation of a standard posterior chamber intraocular lens (IOL) in a patient with bilateral cataract and anterior megalophthalmos. After extracapsular cataract extraction, the IOL was sutured to the posterior surface of the iris and anterior capsule. Different types of IOLs were used in each eye, and the surgical technique was adapted to the characteristics of the IOL. No complications were noted. Visual rehabilitation was successful. Extracapsular cataract extraction with a posterior chamber IOL sutured to the posterior surface of the iris and anterior capsule is a useful option in patients with anterior megalophthalmos and cataract.

Cataract extraction and intraocular lens implantation in anterior megalophthalmos

Six eyes of 4 patients with anterior megalophthalmos, 2 men and 2 women ranging in age from 32 to 47 years, had extracapsular cataract extraction or phacoemulsification and standard posterior chamber intraocular lens implantation. All had a family history of anterior megalophthalmos. Follow-up was from 6 to 30 months. All patients had a preoperative visual acuity of worse than 20/60, which improved to 20/20 in 5 eyes. Zonular dehiscence was observed during surgery in 3 cases, leading to vitreous loss in 1 case that developed a retinal detachment after 3 months.

Cataract surgery and intraocular lens implantation in anterior megalophthalmos

Objective: A case is described of a patient with X-linked megalocornea (XLM) who underwent bilateral consecutive phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. Methods: A 49-year-old man referred to us for cataract extraction was found to have XLM with mosaic corneal dystrophy. Pseudoexfoliation of the lens capsule was present in the right eye. Phacoemulsification was planned, and the Holladay II formula was used to calculate the IOL power. Results: During phacoemulsification, anomalies of the capsule and zonule were observed bilaterally. At the last examination (follow-up 28 months OS, 13 months OD), best spectacle-corrected vision was 20/20 in both eyes, but the IOL was slightly decentered in the right eye. Conclusions: Corneal enlargement and mosaic dystrophy are obvious features of XLM. Anomalies involving the anterior structures of the eye and in particular the lens capsule and zonule are also frequent. Cataract extraction with phacoemulsification and PC IOL implantation can be successful, but special attention must be paid to both surgical technique and IOL selection.

Cataract extraction in X-linked megalocornea: a case report.

This report describes different modes of management in 3 sisters with anterior megalophthalmos. We report our management of the anterior megalophthalmos and a new technique of anterior chamber intraocular lens implantation, which was used in 1 case.

Anterior megalophthalmos in a family with 3 female siblings

We report three cases of extracapsular cataract extraction with intraocular lens implantation in two patients with anterior megalophthalmus. This is the first report, to our knowledge, of intraocular lens implantation in this rare condition.

Belfort Júnior R

Papers

Intraocular lens implantation in anterior megalophthalmus. Case report.