Is it a coloboma or not? A new definition for isolated lens coloboma: focal zonular dysgenesis
Year: 2023
Type: article
Study design: Case Report
Abstract: Purpose: Ocular coloboma is defined as a congenital malformation caused by defective closure of the fetal fissure, resulting in a notch in any structure. However, the entity known as “isolated lens coloboma” does not seem to have a similar etiological basis with other ocular colobomas. This congenital malformation can induce an important decrease of the visual acuity, and facectomy has an increased risk for intraoperative and postoperative complications. Better surgical planning could be achieved with an accurate definition of the diagnosis and pathophysiology of this lens abnormality, as the extent and mechanism of zonular disease will have a significant impact on the selection of the modality of intervention. Methods: Nine eyes of seven patients, who were diagnosed with “isolated lens coloboma” and underwent phacoemulsification and implant of intraocular lens (IOL), were studied (retrospective case series). The surgeries were performed by four different surgeons, according to their preferred technique, in the last 5 years. Results: There were no intraoperative complications. Two (22.22%) eyes presented postoperative complications, one of which was the IOL decentralization. Conclusion: Considering the ocular morphogenesis and the definition of coloboma, the ideal denomination for the congenital malformation traditionally known as isolated lens coloboma would be “focal zonular dysgenesis.” The best surgical approach, contemplating the pathophysiology, in addition to the cases described and review of literature, is discussed.
Authors: Nicole B. Larivoir, Paula M. Marinho, Ivan C. Teixeira, Gabriel B. De Figueiredo, Rodrigo A. B. Fernandes, Lincoln L. Freitas
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4390226237