Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma

Cataract may cause severe visual impairment in eyes with microphthalmos (MO) and uveal coloboma (UC). 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 MO and UC.

This retrospective comparative study included 19 eyes with MO and 20 with UC. Preoperative, intraoperative, and postoperative data of eyes that underwent cataract surgery were analysed.

MO eyes had lower high-hardness nucleus rates (p = 0.002) than UC. The most common preoperative complications in the MO and UC 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 UC group. Combined surgery was mainly used to deal with high or unstable intraocular pressure (IOP; 77%) in the MO group versus posterior pars plana vitrectomy (85.71%) in the UC group to treat vitreoretinal pathologies. Corrected distance visual acuity was significantly improved in both MO (p = 0.0005) and UC (p < 0.001) groups, while IOP was decreased (p = 0.03) in the MO group.

Eyes with MO and UC 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.