A 67-year-old woman presented with features of bilateral cataract and lens coloboma. The lens coloboma was from 1 to 8 o’clock and from 5 to 9 o’clock positions in right and left eye, respectively. With some modifications, phacoemulsification was performed in both eyes at an interval of 1 month. A smaller (4.5 mm) anterior capsulorrhexis was made due to poor peripheral lenticular support. Three iris retractors were used to stabilise anterior capsulorrhexis margin to the limbus. Phacoemulsification was performed by direct chop technique under low phacodynamics. A capsular tension ring was placed in a bag followed by tangential cortical clean up and implantation of a foldable intraocular lens (IOL). One month following surgery, both eyes had a visual acuity of 20/20 with a stable IOL. This case report highlights the rarest malformation of the lens with cataract and its successful management by phacoemulsification using iris retractors as capsule supporting device.
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