Dr.Jagat Ram

, Dr. SIMAR RAJAN SINGH, Dr.Parul Chawla Gupta, Dr. SUSHMITA KAUSHIK

Abstract

We describe a ‘novel’ Mega Phakic Intraocular Lens as a solution for high anisometropia due to unilateral buphthalmos. A 5-year-old boy with unilateral buphthalmos presented with visual acuity of counting fingers and unilateral high myopia with significant astigmatism (-13Ds / -4Dc @ 20 degree). The axial length was 29mm. Given the high anisometropia and concomitant amblyopia, this eye warranted surgical management. After extensive brainstorming and excluding all other viable options, we designed a novel, customized, toric, phakic intraocular lens. The lens design conjured had a maximum diagonal length of 15mm with inbuilt power to correct the pre-existing astigmatism. Post-operatively, the child showed a successful visual outcome with an unaided visual acuity of 20/30 and vault height of 420 microns. Amblyopia therapy was initiated, and he continues to maintain stable intraocular pressures and no visual axis opacification at over one year of follow up.