Successful toric intraocular lens implantation for cataract in a patient with congenital uveal coloboma combined with microcornea: a case report

Background Uveal coloboma is caused by incomplete embryonic optic fissure closure, frequently associated with microcornea, early cataract. Measurement of parameters, difficult intraoperative conditions and capsular contraction will all limit Toric intraocular lens (TIOL) use in these complex eyes. We report a relevant case for clinical reference. Case presentation A 50-year-old woman presented with bilateral inferior uveal coloboma, microcornea, grade 3 nuclear cataract and corneal astigmatism, with marked corneal astigmatism in the right eye. Preoperative uncorrected visual acuity was counting fingers in the right eye and 20/500 in the left eye. After accurate biometry and TIOL calculation, uncomplicated bilateral phacoemulsification with TIOL implantation was performed. The best-corrected visual acuity (BCVA) improved from 20/500 to 20/33 in the right eye, and 20/200 to 20/25 in the left one. Right anterior capsular contraction was treated with Nd: YAG laser capsulotomy at 2 months after the surgery. Slit‑lamp examination suggested satisfactory IOL alignment in both eyes during the 8‑month follow‑up, with good visual outcomes. Conclusion In this single case, toric IOL implantation was a feasible surgical option for a patient with concurrent congenital uveal coloboma and microcornea. Accurate preoperative biometric assessment, precise intraoperative alignment of TIOL axis and long‑term surveillance for anterior capsular phimosis are important to secure satisfying postoperative visual outcomes.