Cataract surgery in a patient with megalocornea – a case report

Introduction
To describe a rare case of a patient with megalocorneas who underwent cataract surgery.

Material and methods
A 52 years old patient with extremely wide corneas 16 mm in diameter in both eyes, was admitted to our department with cataract diagnosis. Four other male members of his family are known to have megalocorneas. This suggests X-linked recessive inheritance. The visual acuities were: 0.9 with correction -3.00 Dsph in the right eye and 0.6 with correction -5.50 Dsph in the left eye. Mosaic corneal dystrophy and slight iridodonesis was found in both eyes. Posterior subcapsular cataracts were seen in both eyes with predominance in the left eye. Moreover, flat peripheral retinal detachment in the lower part of the eye fundus was found, which was presumably long-lasting. Phacoemulsification through the clear corneal temporal micro-incision of 1.8 mm and the foldable intraocular lens (IOL) implantation in the left eye were performed. The IOL refractive power was calculated with IOL Master and with standard contact ultrasound biometry. Preventive laser photocoagulation of the retina was performed in the right eye.

Results
No intraoperative and postoperative complications were observed. Two weeks after cataract surgery corrected visual acuity in the left eye was 1.0 with correction +1.00 Dsph. The patient was very satisfied with the surgery result.

Conclusions
Phacoemulsification with an implantation of foldable IOL in patients with megalocornea may be a safe procedure with very good functional results. Precise IOL power calculation may be difficult to achieve.