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    Repair of Congenital Iris Coloboma, but Substantially Improved Using Anatomical Considerations

    AAO 2022 Video Program
    Cataract/Anterior Segment, Cornea/External Disease, IOLs and Implantation

    Congenital iris colobomas do not typically affect one's vision prior to cataract formation. Visual and optical issues can occur at the time of cataract surgery when an intraocular lens—typically half the diameter of the crystalline lens—is placed. Leaving a coloboma unrepaired or sutured closed without addressing the iris sphincter muscle in the coloboma often creates these issues. The sphincter tissue has previously been considered with a technique that separates the normal iris sphincter and the colobomatous iris sphincter; however, this still usually requires the creation of an iridodialysis for closure of the defect. The technique presented here removes the iris sphincter from the sides of the iris coloboma, converting the tissue essentially to iris stroma. This allows closure of the colobomatous iris, with improved pupil centration and sphericity. In addition, this particular case has a congenital lens coloboma that is also managed during the concomitant cataract surgery.

    Financial Disclosure: Dr. Gregory Ogawa discloses a financial relationship with VisionQuest Biomedical (Stock Options - Public or Private).

    Logan Wolfel discloses no financial relationships.