{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:23:48Z","timestamp":1787822628648,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271067"],"award-info":[{"award-number":["82271067"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82271067"],"award-info":[{"award-number":["82271067"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Cataract surgery in eyes with congenital iris\u2013choroidal coloboma is technically challenging, and postoperative intraocular lens (IOL) alignment and objective optical quality remain insufficiently characterized. This study evaluated short-term surgical outcomes, early postoperative IOL alignment, and objective optical quality after phacoemulsification with IOL implantation in eyes with congenital iris\u2013choroidal coloboma and cataract. Methods: This retrospective comparative study included 36 eyes with congenital iris\u2013choroidal coloboma complicated by cataract and 31 eyes with age-related cataract. All eyes underwent phacoemulsification with in-the-bag monofocal IOL implantation. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), early postoperative IOL tilt and decentration, and objective optical quality parameters, including modulation transfer function (MTF) and Strehl ratio (SR), were evaluated 1 month postoperatively. Multivariable linear regression analyses were performed to identify factors associated with postoperative BCVA and IOL tilt in coloboma eyes. Results: BCVA improved significantly after surgery in coloboma eyes (p &lt; 0.001), although postoperative BCVA remained worse than that in age-related cataract eyes after adjustment for age (p &lt; 0.001). IOP showed no statistically significant change in either group. Coloboma eyes exhibited greater IOL tilt and decentration than age-related cataract eyes (7.60 vs. 4.10\u00b0 and 0.40 vs. 0.14 mm, respectively; age-adjusted p &lt; 0.001 and p = 0.004), with lower MTF and SR (among eyes with evaluable aberrometry, 17 coloboma eyes and 30 age-related cataract eyes, all p &lt; 0.001). Macular and\/or optic disc involvement was associated with worse postoperative BCVA and greater postoperative IOL tilt. Conclusions: Phacoemulsification with IOL implantation was associated with short-term visual acuity improvement in eyes with congenital iris\u2013choroidal coloboma. These eyes showed greater early postoperative IOL tilt and decentration than age-related cataract eyes, while the evaluable subgroup showed poorer objective optical quality. Macular and\/or optic-disc involvement was associated with worse postoperative BCVA and greater IOL tilt.<\/jats:p>","DOI":"10.3390\/jcm15176616","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:00:35Z","timestamp":1787821235000},"page":"6616","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cataract Surgery in Eyes with Congenital Iris\u2013Choroidal Coloboma: Quantitative Assessment of Intraocular Lens Alignment and Optical Quality"],"prefix":"10.3390","volume":"15","author":[{"given":"Yuxuan","family":"Jia","sequence":"first","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enjie","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6458-3944","authenticated-orcid":false,"given":"Zhenyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xijin","family":"Wu","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefei","family":"Ding","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2766-482X","authenticated-orcid":false,"given":"Peilin","family":"Yue","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8036-5936","authenticated-orcid":false,"given":"Xudong","family":"Song","sequence":"additional","affiliation":[{"name":"Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1038\/s41433-021-01501-5","article-title":"Ocular coloboma-a comprehensive review for the clinician","volume":"35","author":"Lingam","year":"2021","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1167\/iovs.10-5263","article-title":"Anophthalmos, microphthalmos, and typical coloboma in the United Kingdom: A prospective study of incidence and risk","volume":"52","author":"Shah","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e003280","DOI":"10.1136\/bmjopen-2013-003280","article-title":"The small eye phenotype in the EPIC-Norfolk eye study: Prevalence and visual impairment in microphthalmos and nanophthalmos","volume":"3","author":"Day","year":"2013","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1016\/j.ajo.2013.06.037","article-title":"Systemic diagnostic testing in patients with apparently isolated uveal coloboma","volume":"156","author":"Huynh","year":"2013","journal-title":"Am. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1016\/j.ophtha.2020.05.028","article-title":"Ocular and Systemic Findings in Adults with Uveal Coloboma","volume":"127","author":"Huryn","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.ajo.2014.06.023","article-title":"Lenticular changes in congenital iridolenticular choroidal coloboma","volume":"158","author":"Mohamed","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.1007\/s00417-020-04915-1","article-title":"Cataract surgery in eyes with congenital ocular coloboma","volume":"258","author":"Phylactou","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"937","DOI":"10.4103\/ijo.IJO_2276_20","article-title":"Cataract surgery in eyes with associated coloboma: Predictors of outcome and safety of different surgical techniques","volume":"69","author":"Kohli","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.4103\/ijo.IJO_405_19","article-title":"Pars-plana vitrectomy with phacofragmentation for hyperdense cataracts in eyes with severe microcornea and chorio-retinal coloboma: A novel approach","volume":"68","author":"Sen","year":"2020","journal-title":"Indian J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4103\/ojo.ojo_114_23","article-title":"The outcome of uveal coloboma patients undergoing manual small incision cataract surgery and intraocular lens implantation","volume":"18","author":"Dhande","year":"2025","journal-title":"Oman J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1136\/bjo.78.5.332","article-title":"Aetiology of severe visual impairment and blindness in microphthalmos","volume":"78","author":"Elder","year":"1994","journal-title":"Br. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/bjophthalmol-2011-300233","article-title":"Cataract surgery in eyes with congenital iridolenticular choroidal coloboma","volume":"96","author":"Chaurasia","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"411","DOI":"10.4103\/tjo.TJO-D-24-00097","article-title":"Retinal detachments associated with choroidal colobomas","volume":"15","author":"Inoue","year":"2025","journal-title":"Taiwan J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000544002","article-title":"Cataract Surgery in Eyes with Microphthalmos and\/or Uveal Coloboma","volume":"68","author":"Wang","year":"2025","journal-title":"Ophthalmic Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1007\/s00417-013-2397-1","article-title":"Outcomes of phacoemulsification in eyes with congenital choroidal coloboma","volume":"251","author":"Khokhar","year":"2013","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1167\/tvst.13.2.19","article-title":"Effect of Decentration, Rotation, and Tilt on Objective Optical Quality of Plate Haptic Toric Intraocular Lenses in the Early Postoperative Period","volume":"13","author":"Hong","year":"2024","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0039-6257(00)00151-X","article-title":"Ocular colobomata","volume":"45","author":"Onwochei","year":"2000","journal-title":"Surv. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/s10792-024-03132-7","article-title":"Couching of cataractous lens in microphthalmic eyes with irido-fundal coloboma: Revisiting the historical technique","volume":"44","author":"Kannan","year":"2024","journal-title":"Int. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ashena, Z., Maqsood, S., Ahmed, S.N., and Nanavaty, M.A. (2020). Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations. Vision, 4.","DOI":"10.3390\/vision4030041"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajo.2018.01.007","article-title":"Inferior Decentration of Multifocal Intraocular Lenses in Myopic Eyes","volume":"188","author":"Zhu","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1097\/j.jcrs.0000000000000219","article-title":"Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery","volume":"46","author":"Chen","year":"2020","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.jcrs.2018.02.025","article-title":"Effect of intraocular lens decentration on image quality tested in a custom model eye","volume":"44","author":"Marcos","year":"2018","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4141","DOI":"10.2147\/OPTH.S327660","article-title":"The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens","volume":"15","author":"Teshigawara","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1097\/OPX.0000000000001004","article-title":"Effect of Decentration on the Optical Quality of Two Intraocular Lenses","volume":"93","author":"Ortiz","year":"2016","journal-title":"Optom. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/01.icu.0000243020.82380.f6","article-title":"Uveal coloboma: Clinical and basic science update","volume":"17","author":"Chang","year":"2006","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jcrs.2009.07.035","article-title":"Real-time intraocular pressure measurement in standard and microcoaxial phacoemulsification","volume":"36","author":"Kreutzer","year":"2010","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.jcrs.2009.01.034","article-title":"Effect of decentration and tilt on the image quality of aspheric intraocular lens designs in a model eye","volume":"35","author":"Eppig","year":"2009","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e31867","DOI":"10.1016\/j.heliyon.2024.e31867","article-title":"Biometric factors associated with the postoperative visual performance of a multifocal intraocular lens","volume":"10","author":"Xu","year":"2024","journal-title":"Heliyon"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"683","DOI":"10.3928\/1081-597X-20021101-04","article-title":"A new intraocular lens design to reduce spherical aberration of pseudophakic eyes","volume":"18","author":"Holladay","year":"2002","journal-title":"J. Refract. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jcrs.2019.01.016","article-title":"Cataract surgery outcomes in eyes with chorioretinal coloboma","volume":"45","author":"Sahay","year":"2019","journal-title":"J. Cataract Refract. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6616\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:13:37Z","timestamp":1787822017000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":30,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176616"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176616","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}