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A Journal on Ophthalmology
Minerva Oftalmologica 2002 September-December;44(3-4):161-7
Cataract and anterior megalophthalmus. Aspects of the surgical technique
Nuzzi R., De Santis U., Russo A., Donati S., Machetta F., Grignolo F. M.
The anterior megalophthalmus (AM) is one of the different clinical forms of megalocornea. Associated to the typical corneal alterations, abnormalities of different structures of the anterior segment can be observed. Cataract could be an early alteration and the surgical intervention is at risk for complications. In the literature different ways of extraction (intra or extracapsular) are reported. The first case of patient with AM subjected to a surgical intervention by facoemulsification in both eyes, is reported. The patient showed capsular and suspension apparatus abnormalities in both eyes, in association with typical corneal alterations. The intervention was applied with different facoemulsification methods. The lastest control showed a visual acuity of 9/10 in both eyes and the IOLs were in position and centred in the capsular structure. Secondary cataract or high intraocular pressure were not observed. The presence of high deep anterior chamber, zonular apparatus and capsular abnormalities are risk factors for cataract surgery (with a reduction of the corneal transparency) in patients with AM. This could be a dangerous factor for surgical complications like posterior capsula rupture or capsular bag disinsertion. However the risk depends on the ability and speed of the operator in the application of the facoemulsification method. A successful surgical intervention follows the correct choice of time and method but many surgical and secondary complications depend not only on the execution time and the ability of the surgeon, but also on the ultrastructural alterations of the anterior segment.