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Curbside Consultation in Neuro-Ophthalmology

Case Reports

Bilateral cataract surgery combined with implantation of a Brown Diaphragm Intraocular Lens after trabeculectomy for congenital aniridia

Ophthalmic Surgery, Lasers and Imaging   Vol. 33   No. 6   November/December 2002
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Salomon Esquenazi, MD and Sandra Amador, MD

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ABSTRACT

A 17-year-old male patient was referred for poorly controlled glaucoma on maximal medication, congenital aniridia, cataract, nystagmus, and hypoplasia of the macula. A bilateral filtering procedure was performed to control the glaucoma. Three months later, a slow motion phacoemulsification and implantation of a brown diaphragm intraocular lens (IOL) was attempted. Despite the presence of nystagmus and hypoplasia of the macula, the visual acuity improved from 20/300 to 20/100 in the right eye and from 20/400 to 20/150 in the left eye. Both aniridia IOLs were well centered, the anterior segment was quiet with normal intraocular pressure without medication, and all of the patient’s glare symptoms disappeared. A single-piece iris diaphragm and optical lens offer a safe alternative for patients who previously had no viable options for iris reconstruction. The most serious postoperative problem, glaucoma, should be addressed before the cataract and lens implantation is performed to avoid a possible acceleration of the glaucoma progression by the large aniridia IOL. [Ophthalmic Surg Lasers 2002;33:514-517]

AUTHORS

From the Centro Oftalmologico Olsabe (SE) and the Department of Ophthalmology, Fundacion San Martin, School of Medicine (SE, SA), Bogota, Colombia.

Accepted for publication May 1, 2002.

Address reprint requests to Salomon Esquenazi, MD, 1631 Valence St., New Orleans, LA 70115.

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