Title : When one anomaly hides another PFV unmasked during cataract surgery in an eye with iris coloboma
Abstract:
Intra operative surprises requiring on the spot decision making and adaptability make pediatric cataract surgery challenging. We present a case of pediatric cataract with iris and lens coloboma planned for cataract extraction with primary posterior capsulorhexis with intra ocular lens implantation found to have anterior persistent fetal vasculature intra operatively. Pre operative slit lamp examination showed there was nasal iris and lens coloboma of 2 clock hours; the lens was cataractous. Fundus examination was hazy due to cataract; posterior pole was normal. Anterior capsulorhexis was completed. There was zonular weakness corresponding to the area of lens coloboma. Rest of the zonules were intact. After lens aspiration, elongated ciliary processes were seen in the area of iris coloboma with persistent tunica vasculosa vessels nasally along the posterior capsule. There was iris and lens coloboma of 4 clock hours. Intraoperative indirect ophthalmoscopy did not reveal a stalk or chorioretinal coloboma. Capsular tension ring was placed. A slightly eccentric primary posterior capsulorhexis was done avoiding the vessels. Anterior vitrectomy was done and intra ocular lens was implanted in the bag. To the best of our knowledge, there are no reports of anterior persistent fetal vasculature presenting with nasal iris and lens coloboma.
