3018: bilateral anterior segment dysgenesis

3018: bilateral anterior segment dysgenesis

Close-up image of two human eyes showing bilateral anterior segment dysgenesis, illustrating the unusual anatomy that presents challenges for cataract surgery.

Navigating cataract surgery in the setting of bilateral anterior segment dysgenesis presents a true 10/10 surgical challenge due to highly irregular anterior anatomy, altered corneal optics, and severely compromised visualization. Cases like this test a surgeon’s full technical repertoire, demanding meticulous pre-operative planning, custom incision placement, and adaptable intraoperative maneuvers to overcome dysplastic iris architecture and peripheral corneal opacities. Using retro-endo-illumination via the pars plana allows for safe completion of the phacoemulsification and stable IOL fixation. Watch the video to see how careful surgical execution and patient intraoperative adjustments turn a daunting anatomical challenge into a successful outcome. What specific surgical modifications or visualization aids do you employ when faced with severe anterior segment malformations? Please comment your strategies below.

video link here

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