RESOLUTION OF POST-CATARACT SURGERY HALOS AFTER YAG LASER POSTERIOR CAPSULOTOMY IN A PATIENT WITH COLOBOMA.

This report presents a unique case of a patient with coloboma who experienced halos after cataract surgery with a monofocal lens and posterior capsule opacity. There is very little previous literature on similar cases due to their low prevalence. The original objective was to evaluate the effect of a small posterior capsulotomy on postoperative halos in a case with iris coloboma and a bilateral monofocal lens.

Halos are an uncommon but problematic side effect of monofocal intraocular lenses. Coloboma, a congenital eye malformation, is characterized by an irregular opening in the iris. This alters the iris's diaphragmatic function and may be associated with other ocular alterations and surgical complications.

Keywords: Iris coloboma, cataracts, monofocal lens, halos, posterior capsulotomy.

Case Report:
A 57-year-old man presented with decreased vision and post-cataract halos. Bilateral monofocal pseudophakia and congenital corectopia were present. Preoperative visual acuity was 0.7 each eye. Slit lamp examination revealed inferior iris colobomas, posterior capsule opacities, and the rest of the ocular examination were normal, including IOP and fundoscopy.
Treatment: A small posterior capsulotomy of 4 mm radius, slightly enlarged superiorly, was performed.

Visual acuity improved to 1.0, halos completely disappeared, the capsulotomy was permeable, and the intraocular lenses maintained centration.

Visual comfort and quality were reported as optimal.

Small posterior capsulotomy may be an effective strategy to reduce or eliminate postoperative halos in patients with iris coloboma and monofocal lenses. It preserves the opacity in the area of the iris defect, minimizing the increase in optical aberration. Additional studies with a larger number of patients are needed to confirm these results.