Coloboma de iris bilateral asociado a catarata madura: reporte de caso y manejo quirúrgico Bilateral iris coloboma associated with mature cataract: case report and surgical management

ABSTRACT Ocular coloboma is a congenital malformation resulting from the defective closure of the embryonic fissure. When associated with a mature cataract and zonular weakness, it significantly increases surgical complexity. This study aims to describe the clinical findings and specialized surgical management of a 61-year-old male patient with bilateral iris coloboma and mature cataracts. A descriptive case report was conducted through a medical record review and multimodal evaluation, including biomicroscopy, specular microscopy, B-scan ultrasound, and optical coherence tomography (OCT). Results revealed a preoperative visual acuity of 20/200, an inferior pear-shaped iris defect, mature cataracts, and 180° of zonular weakness in both eyes. OCT confirmed the extension of the coloboma to the choroid and retina, with a posterior staphyloma in the left eye. Phacoemulsification was performed on the right eye with a capsular tension ring (CTR) implantation and anterior vitrectomy. At the six-month follow-up, a best-corrected visual acuity of 20/70 and intraocular pressure stability were achieved without late complications. In conclusion, comprehensive characterization using advanced imaging is decisive for surgical planning. The use of capsular support devices and vitrectomy techniques optimizes visual outcomes and anatomical stability in severe ocular malformations, even in resource-limited settings where the efficacy of a single intervention is a priority.