Phacoemulsification in anterior megalophthalmos: rhexis fixation technique for intraocular lens centration

Abstract

We describe phacoemulsification in both eyes of a patient with anterior megalophthalmos. Surgery in such cases can be challenging because of a deep anterior chamber, enlarged ciliary ring, weakened zonules, and large capsular bag. Phacoemulsification performed through a scleral tunnel resulted in a stable wound. We report the use of anterior optic capture technique (optic within the capsulorhexis margin, haptics in the sulcus) for successful intraocular lens implant centration.

Rhexis fixation of intraocular lens in a case of buphthalmos with cataract

“…Literature pertaining to cataract surgery in buphthalmos is scanty. Rhexis fixation of IOL has been described in patients with anterior megalophthalmos but has never been used in buphthalmic eyes with cataract (Jain AK et al, 2014). Also, to the best of our knowledge, no report in literature mentions phacoaspiration with a 3-piece hydrophobic acrylic IOL using the novel technique of rhexis fixation as was done in our case.…”

Cataract surgery and intraocular lens power calculation in a patient with anterior megalophthalmos with normal sized crystalline lens: Case report

“…Cataract extraction in eyes with anterior megalophthalmos is complex because of hyper-deep anterior chamber, zonular laxity and poor visualization. Enlargement of the ciliary ring is often associated with a wide capsular bag, so various methods to secure intraocular lens implant in these circumstances were described in literature: iris fixated artificial lens (10,11), sutured posterior chamber IOL (12,13), anterior capsulorhexis capture of the IOL (14), and custom-made intraocular lens with very wide haptic diameter (4). However, crystalline lens is not always large.…”

“…An interesting approach to IOL power calculation was utilized by Jain et al (14). They used SRK II formula, and added 2 D to emmetropic calculation.…”

Ultrasound Biomicroscopy and Scheimpflug Imaging in Anterior Megalophthalmos: Changes Seen after Cataract Surgery

“…A diagnosis of anterior megalophthalmos was made and phacoemulsification with posterior chamber intraocular lens implantation (PCIOL) was performed first in the right eye followed by the left four weeks later. The IOL power calculations and procedure of phacoemulsification were reported by the authors in a previous report [ 5 ]. SRK II formula was used for biometry and 2 dioptres (D) was added to the emmetropic IOL power to err towards myopic postoperative refraction [ 5 ].…”

“…The IOL power calculations and procedure of phacoemulsification were reported by the authors in a previous report [ 5 ]. SRK II formula was used for biometry and 2 dioptres (D) was added to the emmetropic IOL power to err towards myopic postoperative refraction [ 5 ]. Phacoemulsification was performed through scleral tunnel in both eyes.…”