Evaluating Predictors of Outcomes and Safety of Various Cataract Surgery Techniques in Eyes with Coloboma: A Research Protocol

Introduction: Coloboma, a congenital defect resulting from the incomplete closure of the embryonal fissure, often affects the inferonasal part of the fundus. It is frequently associated with cataracts, which are a leading treatable cause of visual impairment. However, cataract surgery in colobomatous eyes presents significant challenges due to anatomical anomalies such as microcornea, zonular instability, poor pupillary dilation and structural irregularities. Need of the study: Cataract development is common in eyes with coloboma and significantly impacts vision, causing blurry vision, glare sensitivity and difficulties with daily activities. Cataract surgery in these eyes poses unique challenges due to the underlying anatomical abnormalities. Understanding the predictors of outcomes and the safety of different surgical techniques is crucial for optimising care and improving visual outcomes for patients with coloboma. By identifying factors associated with better or worse results, surgeons can tailor their approach to each individual patient, reducing risks and enhancing the chances of successful visual rehabilitation. Aim: The aim of this study is to evaluate different cataract surgeries for eyes with colobomas, as well as the safety and outcome predictors of various surgical methods. Materials and Methods: This hospital-based prospective interventional study will be conducted at the Department of Ophthalmology, Acharya Vinobha Bhave Rural Hospital, Sawangi, Maharashtra, India, over two years (May 2024 - April 2026) with 34 patients. The study aims to evaluate the outcomes and safety of cataract surgery techniques, including Phacoemulsification (PE) and Manual Small Incision Cataract Surgery (M-SICS). The type of surgery will depend on the degree of microcornea, cataract hardness and zonular stability. Preoperative, intraoperative and postoperative assessments will include detailed ophthalmic evaluations, visual acuity measurements, grading of microcornea and monitoring for complications such as corneal edema, using standardised grading systems. Statistical analysis will be performed using Statistical Package for the Social Sciences (SPSS)-version 23 to identify predictors of surgical outcomes, with significance set at p<0.05. The study seeks to improve surgical techniques, enhance patient safety and provide insights into counseling and risk stratification for individuals with coloboma-associated cataracts.