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W Wu, SG Elner, D Dawson, K Meyer, A Sugar, SE Moroi; Postoperative Outcome And Complications Following Ocular Surgery In Patients With Nanophthalmos . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1099.
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Purpose:To evaluate the surgical outcome and complications of a series of patients with nanophthalmos. Methods:Retrospective review of consecutive patients with nanophthalmos, who had ocular surgeries April 1985 through January 2001. Preoperative diagnoses, visual acuity results, and complications were assessed. Biometric data were obtained for corneal diameter, keratometry, axial length, and choroid-scleral thickness determined on B-scan echography. Results:Seven patients had a mean age at their first visit of 49.3 + 18.0 (SD). Two patients were not previously diagnosed with nanophthalmos. The comorbid preoperative ocular diagnoses included: hyperopia, amblyopia, angle-closure glaucoma, uveal effusion, and cystoid macular edema. Four eyes had procedures elsewhere. Eleven eyes underwent ocular surgery at our institution with an average of 5.4 surgeries per patient. Six eyes had cataract extraction with two eyes showing no improvement, and four eyes had variable improvement of visual acuity. No eye lost vision after cataract surgery. Cataract surgery complications included severe iritis, broken haptic of an intraocular lens, and posterior capsule opacities. Five eyes had glaucoma procedures (4 had laser procedures and 1 had filtration surgery). Aqueous misdirection developed after trabeculectomy in the one eye. Uveal effusion syndrome occurred in three eyes of two patients, and was treated by scleral window resections with complications of recurrent effusion and dellen. One patient underwent removal of a failed epikeratophakia graft and developed moderate postoperative inflammation. No eye lost vision after any of these noncataract surgeries. Conclusion:Our limited case series affirms that eyes with nanophthalmos are prone to surgical complications, and are technically difficult requiring multiple surgeries. Accurate preoperative diagnosis is important to plan surgeries appropriately. In addition to the simple biometric measurements of corneal diameter and axial length, attention to combined choroid-scleral thickness measurements on conventional B-scan echography is helpful in the diagnosis of nanophthalmos.
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