J Korean Ophthalmol Soc.  2010 Jul;51(7):941-948. 10.3341/jkos.2010.51.7.941.

Clinical Results of Cataract Surgery in Nanophthalmic Eyes

• Jung KI
• Yang JW
• Lee YC
• Kim SY

• KMID: 2213759
• DOI: http://doi.org/10.3341/jkos.2010.51.7.941

Abstract

PURPOSE
To evaluate the outcomes in patients with nanophthalmos that had phacoemulsification and intraocular lens (IOL) implantation.
METHODS
This retrospective study included 13 eyes of eight patients with nanophthalmos who had phacoemulsification with IOL implantation: Preoperative and postoperative manifest refraction, best-spectacle corrected visual acuity (BSCVA), preoperative axial length, anterior chamber depth, corneal diameter, manual keratometry, intraocular pressure (IOP), and postoperative complications were analyzed.
RESULTS
Eight patients (13 eyes) had phacoemulsification with IOL implantation, 11 eyes by posterior chamber IOL implantation, and two eyes by ciliary sulcus fixation. The mean change in visual acuity from preoperative to postoperative was 2.1+/-2.0 lines. IOP was well controlled postoperatively, but one eye required a trabeculectomy. No patients required partial sclerotomy during the operation. Choroidal effusions or choroidal detachment was not observed intraoperatively or postoperatively. The mean endothelial cell loss was 12.6+/-17.7% at two months postoperative.
CONCLUSIONS
The results of phacoemulsification and IOL implantation through clear corneal incision in nanophthalmic patients are encouraging. Most patients showed improved visual acuity without severe complications.

Keyword

Intraocular lens implantation; Nanophthalmos; Phacoemulsification

MeSH Terms

Anterior Chamber
Cataract
Choroid
Endothelial Cells
Eye
Humans
Intraocular Pressure
Lens Implantation, Intraocular
Lenses, Intraocular
Phacoemulsification
Postoperative Complications
Retrospective Studies
Trabeculectomy
Visual Acuity

Reference

References

1. Hirsch SE, Waltman SR, LaPiana FG. Bilateral nanophthalmos. Arch Ophthalmol. 1973; 89:353.

2. Bateman J. Microphthalmos in development abnormalities of the eye. Int Ophthalmol Clin. 1984; 24:87–106.

3. Warburg M. Genetics of microphthalmos. Int Ophthalmol. 1981; 4:45–65.

4. Apple DJ, Rabb MF. Ocular Pathology: Clinical applications and self-assessment. 4th ed.St. Louis: Mosby;1991. p. 36–7.

5. Weiss AH, Kousseff BG, Ross EA, Longbottom J. Complex micro-phthalmos. Arch Ophthalmol. 1989; 107:1619–24.

6. Weiss AH, Kousseff BG, Ross EA, Longbottom J. Simple micro-phthalmos. Arch Ophthalmol. 1989; 107:1625–30.

7. Brockhurst RJ. Nanophthalmus with uveal effusion: a new clinical entity. Trans Am Ophthalmol Soc. 1974; 72:371–403.

8. Ryan EA, Zwaan J, Chylack LT Jr. Nanophthalmus with uveal effusion: clinical and embryologic considerations. Ophthalmology. 1982; 89:1013–7.

9. Singh OS, Simmons RJ, Brockhurst RJ, Trempe CL. Nanophthalmus: a perspective on identification and therapy. Ophthalmology. 1982; 89:1006–12.

10. Spencer WH. Ophthalmic Pathology: An Atlas and Textbook. 3rd ed.Philadelphia: WB Saunders;1985. p. 241.

11. O'Grady RB. Nanophthalmos. Am J Ophthalmol. 1971; 71:1251–3.

12. Kimbrough RL, Trempe CS, Brockhurst RJ, Simmons RJ. Angle-closure glaucoma in nanophthalmos. Am J Ophthalmol. 1979; 88:572–9.

13. Brockhurst RJ. Nanophthalmos with uveal effusion. A new clinical entity. Arch Ophthalmol. 1975; 93:1989–99.

14. Susanna R Jr. Implantation of an intraocular lens in a case of nanophthalmos. CLAO J. 1987; 13:117–8.

15. Wayne Wu, Daniel G, Dawson , et al. Cataract surgery in patients with nanophthalmos: results and complications. J Catract Refract Surg. 2004; 30:584–90.

16. Lee KW, Yoo SH. A case of bilateral complicated microphthalmos. J Korean Ophthalmol Soc. 1983; 24:599–603.

17. Warburg M. Microphthalmos and colobomata among mentally re-tarded individuals. Acta Ophthalmol. 1981; 59:665–73.

18. Khairallah M, Messaoud R, Zaouali S, et al. Posterior segment changes associated with posterior microphthalmos. Ophthalmology. 2002; 109:569–74.

19. Auffarth GU, Blum M, Faller U, et al. Relative anterior micro-phthalmos: morphometric analysis and its implications for cataract surgery. Ophthalmology. 2000; 107:1555–60.

20. Cross HE, Yoder F. Familial nanophthalmos. Am J Ophthalmol. 1976; 81:300–6.

21. Kim CS, Kim SY, Park YH, Lee YC. Change in ocular dimensions with age in patients with emmetropia. J Korean Ophthalmol Soc. 2008; 49:425–32.

22. Altintas AK, Acar MA, Yalvac IS, et al. Autosomal recessive nano-phthalmos. Acta Ophthalmol Scand. 1997; 75:325–8.

23. Buys YM, Pavlin CJ. Retinitis pigmentosa, nanophthalmos, and optic disc drusen: a case report. Ophthalmology. 1999; 106:619–22.

24. MacKay CJ, Shek MS, Carr RE, et al. Retinal degeneration with nanophthalmos, cystic macular degeneration, and angle closure glaucoma; a new recessive syndrome. Arch Ophthalmol. 1987; 105:366–71.

25. Ghose S, Sachdev MS, Kumar H. Bilateral nanophthalmos, pig-mentary retinal dystrophy, and angle closure glaucoma—a new syndrome? Br J Ophthalmol. 1985; 69:624–8.

26. Calhoun FP Jr. The management of glaucoma in nanophthalmos. Trans Am Ophthalmol Soc. 1975; 73:97–122.

27. Neelakantan A, Venkataramakrishnan P, Rao BS, et al. Familial nanophthalmos: management and complications. Indian J Ophthalmol. 1994; 42:139–43.

28. Jin JC, Anderson DR. Laser and unsutured sclerotomy in nano-phthalmos. Am J Ophthalmol. 1990; 109:575–80.

29. Brockhurst RJ. Cataract surgery in nanophthalmic eyes. Arch Ophthalmol. 1990; 108:965–7.

30. Chan FM, Lee L. Nanophthalmic cataract extraction. Clin Exp Ophthalmol. 2004; 32:535–8.

31. Merkur A, Damji KF, Mintsioulis G, Hodge WG. Intraocular pressure decrease after phacoemulsification in patients with pseudoexfoliation syndrome. J Cataract Refract Surg. 2001; 27:528–32.

32. Hayashi K, Hayashi H, Nakao F, Hayashi F. Effect of cataract surgery on intraocular pressure control in glaucoma patients. J Cataract Refract Surg. 2001; 27:1779–86.

33. Johnson MW, Gass JD. Surgical management of the idiopathic uveal effusion syndrome. Ophthalmology. 1990; 97:778–85.

34. Faucher A, Hasanee K, Rootman DS. Phacoemulsification and intraocular lens implantation in nanophthalmic eyes. J Cataract Refract Surg. 2002; 28:837–42.

35. Yuzbasioglu E, Artunay O, Agachan A, Bilen H. Phacoemulsification in patients with nanophthalmos. Can J Ophthalmol. 2009; 44:534–9.

36. Gayton JL, Sanders VN. Implanting two posterior chamber intra-ocular lenses in a case of microphthalmos. J Cataract Refract Surg. 1993; 19:776–7.

37. Rita Mencucci, Claudia Ponchietti, Gianni Virgili, et al. Corneal endothelial damage after cataract surgery: Microincision versus standard technique. J Cataract Refract Surg. 2006; 32:1351–4.

38. Storr-Paulsen A, Norregaard JC, Ahmed S, et al. Endothelial cell dam-age after cataract surgery divide-and-conquer versus phaco-chop technique. J Cataract Refract Surg. 2008; 34:996–1000.

39. Yachimori R, Matsuura T, Hayashi K, Hayashi H. Increased intra-ocular pressure and corneal endothelial cell loss following phacoe-mulsification surgery. Ophthalmic Surg Lasers Imaging. 2004; 35:453–9.