Dr.ARJUN VELAYUDHAN NAIR, Dr.Kalpana Narendran
Nanophthalmos presents an array of challenges even to seasoned cataract surgeons. We demonstrate a 71 year old patient with bilateral nanophthalmos who had uneventful cataract extraction in the right eye with primary implantation of 2 intraocular lenses (IOLs) of 2 different materials
Patient had an axial length of 16.56mm, lens thickness of 5.66mm and a calculated IOL power of 50.50D. Patient underwent a combined clear corneal phacoemulsification and superior sclerocorneal tunnel approach to implant a foldable acrylic and a rigid PMMA IOL into the capsular bag.
Patient preoperatively had an UCVA of 20/600 improving to 20/200 ) with sphere of +10D and cylinder of +1D in his right eye with nuclear sclerosis of grade 3. Immediate post operative period patient had an uncorrected vision of 5/60 (1.1 LogMAR) and a pinhole vision of 6/60 (1 LogMAR).
Piggyback surgery gives the patient better uncorrected visual acuity than implantation of single IOL of maximum available power.
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