UNASSIGNED: To describe the use of FLACS (Femtosecond-Laser-Assisted Cataract Surgery) and pupiloplasty technique employed in a cataract surgery associated with iris-lens-zonule coloboma, as well as to report the advantages that FLACS can provide in this type of complicated surgery.
UNASSIGNED: During FLACS (Victus® - TECHNOLAS, Bausch and Lomb Incorporated, USA), after the docking procedure, the parameters of capsulotomy, fragmentation and incisions were manually adjusted. Iris retractors were anchored to the edge of the anterior lens capsule to provide stability to the bag during phacoemulsification maneuvers, and a capsular tension ring and intraocular lens (IOL) were implanted. Iris repair was approached using a modification of the slip-knot technique. For this purpose, a 10.0 Prolene on a straight needle was used and knotted extraocularly, over the conjunctiva. Finally, an anterior vitrectomy was performed as a precaution.
UNASSIGNED: In spite of the existing controversy regarding FLACS technology compared to conventional surgery, it seems to be beneficial in complicated cases such as cataracts associated with iris and lens coloboma, since it allows the modification of different parameters that facilitate and ensure surgery safety. On the other hand, the iris repair technique described facilitates manipulation of the iris sutures. In addition, complementary techniques such as the use of a capsular tension ring and pupiloplasty help to center and stabilize the IOL, and to reduce the symptoms derived from iris coloboma, obtaining a better visual quality.

UNASSIGNED: Coloboma means curtailed in Greek language. It is mainly used when normal tissue of the eye or another organ is not present since birth. Coloboma is a congenital abnormality mainly caused by incomplete closure of the embryonic fissure of the choroid part of eye.
UNASSIGNED: The aim of this case report is to share the clinical findings in a patient with bilateral iris coloboma, low vision, and headache.
UNASSIGNED: Case report.
UNASSIGNED: An eleven-year-old boy with low vision and headache visited the University Eye Hospital of Kabul University of Medical Science (UEHKUMS) for consultation. Ophthalmic examination revealed a bilateral iris coloboma without concomitant chorioretinal defect, refractive error, and high intraocular pressure in both eyes. The refractive error of the patient was corrected by advising proper glasses, and the high intraocular pressure was controlled by anti-glaucoma drops. After several follow-up visits, the patient no longer complained of headache and low vision.
UNASSIGNED: Visiting patients with iris coloboma should be considered for intraocular pressure (IOP) check, and screening of other family members is mandatory.

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OBJECTIVE: Duane retraction syndrome (DRS) is a congenital syndrome characterized by limitation in adduction and/or abduction eye movements and narrowing of the palpebral fissure in adduction, and may include globe retraction, upshoot or downshoot. Several systemic abnormalities, syndromes, and additional ocular findings can accompany DRS. This study is an evaluation of eye findings in patients with DRS.
METHODS: The records of 632 patients with DRS who were followed up between 1995 and 2016 were reviewed retrospectively. Patients with a follow-up of less than 6 months and patients with a history of eye/cranial trauma or injury were not included in the study. Before the patients were examined, a detailed anamnesis was obtained. Details of the medical records, including additional systemic diseases, were recorded.
RESULTS: The average of follow-up time was 45 months (min-max: 6-128 months). There were 255 male and 377 female patients. A total of 34 patients (5.4%) had additional ocular abnormalities. The most frequently observed ocular pathologies associated with DRS were congenital ptosis (n=6, 0.94%) and coloboma of the iris (n=4, 0.63%).
CONCLUSIONS: Most cases of DRS are observed as isolated. However, various ocular and systemic abnormalities and syndromes are associated with DRS. In particular, synkinetic syndromes may frequently be seen alongside DRS. Therefore, a complete ocular examination and anamnesis are crucial in cases with DRS.

Cat eye syndrome (CES) is a rare chromosomal disorder with a known incidence of 1 per 50,000-150,000 live newborns. The classic triad of iris coloboma, anorectal malformations, and auricular abnormalities is present in 40% of patients. In addition, other ocular malformations and systemic defects can be present. The aim of this report is to present a patient with unilateral iris coloboma related to a mosaicism of cat eye syndrome.
A complete ophthalmological and systemic evaluation was performed in a three-year-old male. He also underwent a standard karyotype and FISH analysis with a probe against the 22q11.2 locus.
The ophthalmological and systemic evaluation revealed a unilateral iris coloboma and ipsilateral auricular malformations. Karyotype analysis of blood leukocytes indicated the presence of a marker chromosome in 6% of the analyzed cells. FISH analysis showed three positive signals in 5.5% of the analyzed nucleus.
This patient presented two of the three classic manifestations of CES; interestingly, they were unilateral. The 22q11 duplication was identified by standard karyotype and confirmed with FISH. The present case demonstrates the importance of conducting a multidisciplinary approach in patients with congenital malformations associated with known syndromes.

This paper reports the technique and outcome of femtosecond laser-assisted cataract surgery (FLACS) in an iris coloboma patient (59-year-old male patient) with bilateral grade 3 cataractous lens and a shallow anterior chamber. Best-corrected visual acuity (BCVA) was 0 on logMAR with spherical equivalent (SE) 9 D in the right eye, and BCVA of 0.3 logMAR with a SE 8.75 D in the left. FLACS was performed on the left then the right eye using the Catalys platform of Johnson & Johnson (intraocular lens implantation of AMO Tecnis 1 ZCB00). Customized parameters were constructed to create capsulotomies of 4.54.7 mm for the left and right eyes, respectively, with manual centration of the distorted pupils. On the second day of follow-up, left-eye BCVA was 0.5 with SE 1 D, and right-eye BCVA was 1 with SE -0.75 D. At the 1-year follow-up, eyes showed stable bilateral Tecnis 1 IOL and refraction. FLACS is a safe surgical option with stable outcomes in cases of cataract with iris coloboma.

Ozurdex® 0.7 mg (dexamethasone 0.7 mg implant, Allergan, Dublin, Ireland), an intravitreal biodegradable implant, is indicated for cystoid macular edema due to various causes. One of its known and uncommon complications is implant migration to the anterior chamber, causing corneal edema that, in some cases, is irreversible. Reported risk factors for device migration are open or defective lens capsule and prior history of vitrectomy. We present a case of dexamethasone implant migration through a congenital iris coloboma in a pseudophakic patient with an intact lens capsule. The patient is a 56-year-old pseudophakic man with a history of congenital iris coloboma, myopia, retinal tears, and a branch retinal vein occlusion with subsequent cystoid macular edema resistant to anti-VEGF medications but responsive to corticosteroids. He presented with sudden painless decreased vision in his left eye, 8 weeks following dexamethasone implant (Ozurdex) injection to the same eye. Upon presentation, he was diagnosed with corneal edema caused by anterior chamber migration of the implant. He was referred for immediate surgical intervention to extract the implant, with a resolution of the corneal edema within 2 weeks postoperatively. To conclude, this is the first case that reports Ozurdex implant migration through an iris coloboma in the setting of an intact posterior capsule. In addition, we describe a novel surgical approach for implant removal from the anterior chamber that is simple and efficient.

Congenital absence of extraocular muscle is rare. The most common extraocular muscle found to be congenitally absent is superior oblique followed by inferior rectus. Patients with absent inferior rectus muscle can present with abnormal head posture and incomitant hypertropia with limitation of ocular motility in the field of action of the inferior rectus with or without torticollis. Microphthalmos, microcornea, coloboma, and Axenfeld-Rieger syndrome are known to be commonly associated with inferior rectus muscle aplasia. Orbital computed tomography (CT) or magnetic resonance imaging before surgery is useful for confirmation of the diagnosis and plan of management. We report satisfactory surgical outcome of anterior transposition of inferior oblique in a case of inferior rectus aplasia with iris coloboma, microcornea, and anomalous insertion of inferior oblique. The patient had right hypertropia in primary position which increased on levoversion and left tilt. Preoperative orbital CT revealed congenital absence of inferior oblique. Peroperatively, congenital absence of inferior rectus was confirmed, and inferior oblique was found to be hyperplastic and abnormally inserted to the sclera. Anterior transposition of inferior oblique was done with satisfactory outcome.

Congenital ocular colobomas are due to incomplete closure of the fetal fissure during organogenesis. Ocular involvement can be variable ranging from a simple hole in the iris to a more severe involvement of the posterior pole (coloboma of the optic nerve, of the choroid, of the retina). We here report the case of a typical isolated bilateral iris coloboma. The study involved a 55-year old woman who discovered a typical inferonasal iris coloboma without involvement of the crystalline or of the posterior pole on ophthalmologic examination.

Vitamin A deficiency is the leading cause of preventable blindness in children worldwide and results in a well-recognized ocular phenotype. Herein we describe a patient presenting to the eye clinic with a retinal dystrophy and ocular colobomata. This combination of clinical signs and consanguineous pedigree structure suggested a genetic basis for the disease, a hypothesis that was tested using whole genome sequencing. Bi-allelic mutations in RBP4 were identified (c.248+1G>A), consistent with a diagnosis of inherited vitamin A deficiency. We describe a constellation of signs that appear to be characteristic for this disease, increasing clinical awareness of this rare condition.