Cataract extraction in X-linked megalocornea: a case report

Objective: A case is described of a patient with X-linked megalocornea (XLM) who underwent bilateral consecutive phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. Methods: A 49-year-old man referred to us for cataract extraction was found to have XLM with mosaic corneal dystrophy. Pseudoexfoliation of the lens capsule was present in the right eye. Phacoemulsification was planned, and the Holladay II formula was used to calculate the IOL power. Results: During phacoemulsification, anomalies of the capsule and zonule were observed bilaterally. At the last examination (follow-up 28 months OS, 13 months OD), best spectacle-corrected vision was 20/20 in both eyes, but the IOL was slightly decentered in the right eye. Conclusions: Corneal enlargement and mosaic dystrophy are obvious features of XLM. Anomalies involving the anterior structures of the eye and in particular the lens capsule and zonule are also frequent. Cataract extraction with phacoemulsification and PC IOL implantation can be successful, but special attention must be paid to both surgical technique and IOL selection.