Cataract surgery in colobomatous eyes: A narrative review of outcome predictors and surgical strategies

ABSTRACT Coloboma is a congenital ocular defect resulting from incomplete closure of the embryonic fissure, often affecting the iris, retina, choroid, or optic nerve. It poses significant surgical and prognostic challenges when associated with cataracts and microphthalmos. This narrative review summarizes current evidence on outcome predictors and surgical strategies for cataract surgery in eyes with coloboma. A literature search was conducted using databases including PubMed and Scopus to identify relevant articles focusing on surgical outcomes, complications, and techniques employed in cataract management in colobomatous eyes. Visual prognosis in colobomatous eyes is influenced by the type and extent of the coloboma, presence of microphthalmos, preoperative visual acuity, and intraoperative complications. Surgical difficulties include small globe size, poor capsular support, and posterior segment anomalies. Strategies such as capsular tension rings, trypan blue-assisted capsulorhexis, and individualized intraocular lens placement are key to optimizing outcomes. Cataract surgery in eyes with coloboma requires a tailored surgical approach guided by anatomical challenges and potential for visual recovery. Early recognition, preoperative planning, and appropriate postoperative rehabilitation are crucial for achieving the best possible outcomes.