Cataract Surgery in Patients with Nanophthalmos: Results and Complications

Abstract

Although phacoemulsification seems to be relatively safe in nanophthalmic eyes, surgeons need to be aware of the challenges of this procedure in these high-risk eyes. Nevertheless, with careful preoperative evaluation and planning, most cases were uncomplicated and resulted in improvement of BCVA.

Cataract Surgery with a New Fluidics Control Phacoemulsification System in Nanophthalmic Eyes

“…Implantation of a single high-power IOL in the capsular bag [2, 3, 4, 5, 6, 7, 8, 9, 11] and piggybacking IOLs in the capsular bag [12] or in both the capsular bag and ciliary sulcus [1, 12] have been commonly attempted in small eyes. In the current study, we implanted a single high-power IOL in the capsular bag in nanophthalmic eyes with an AL of <20 mm without major complications.…”

“…Malyugin ring can be used for mechanical pupillary dilation during cataract surgery in eyes with small pupil and deep AC. However, during the first-eye surgery, the Healon GV injected was forced out of the eye by the high posterior pressure [7, 8]. There was insufficient space to place the Malyugin ring in the eye.…”

“…The reported rates of uveal effusion and PC tear in nanophthalmic eyes were up to 9.3% [2, 3, 5, 7, 8] and 11.7% [2, 3, 5, 7, 8], respectively. Intravenous mannitol is often administered preoperatively to lower the vitreous pressure prophylactically to decrease the posterior pressure [1, 3, 5, 6, 7, 9].…”

“…Nanophthalmos is a rare condition characterized by a small globe with short axial length (AL) and no ocular malformation [1, 2, 3, 4, 5, 6, 7, 8]. Typical features of nanophthalmic eyes include thickened sclera [6, 7, 8], high hyperopia [2, 4, 6, 7, 8], a proportionally very shallow anterior chamber (AC) [1, 3, 4, 6, 7], and narrow AC angle [1, 4, 6, 8].…”

“…Typical features of nanophthalmic eyes include thickened sclera [6, 7, 8], high hyperopia [2, 4, 6, 7, 8], a proportionally very shallow anterior chamber (AC) [1, 3, 4, 6, 7], and narrow AC angle [1, 4, 6, 8]. Cataract surgery is challenging in these eyes because of the small working space, which increases the risk of damaging the intraocular tissues [3, 5]; uveal effusion may occur more easily because of the inherent scleral properties [2, 5, 9].…”