| Sumario: | Congenital aniridia is a rare genetic eye disorder often associated with PAX6 gene mutations, leading to complex ocular manifestations, including aniridia-associated keratopathy (AAK) and cataracts. The surgical management of cataracts in these patients is particularly challenging due to severe corneal opacities, which obscure key surgical steps such as capsulorhexis and phacoemulsification. This report presents two cases of congenital aniridia with severe AAK, in which chandelier retroillumination-assisted cataract surgery was employed. This technique, typically used in vitreous surgery, provided enhanced visualization of the lens through posterior segment illumination, facilitating successful cataract extraction and intraocular lens implantation. Both patients showed significant postoperative improvement in visual acuity. These cases demonstrate the feasibility and effectiveness of chandelier retroillumination-assisted cataract surgery in patients with congenital aniridia complicated by severe corneal opacity. Plain language summary Chandelier lighting-assisted cataract surgery in two cases of congenital aniridia Congenital aniridia is a rare genetic eye condition that often involves problems with a gene called PAX6. It affects the eyes in various ways, including causing cloudy corneas and cataracts, where the lens of the eye becomes cloudy. Performing cataract surgery on patients with this condition is tricky because the cloudy corneas make it hard for surgeons to see clearly during the operation. This report discusses two patients with congenital aniridia who had severe clouding of their corneas. To help with their cataract surgery, the surgeons used a special technique called chandelier retroillumination, which shines light from behind the lens, making it easier for the surgeon to see and remove the cataracts. The surgery was successful for both patients, and they experienced noticeable improvements in their vision after the procedure. These cases show that using this special lighting technique can make cataract surgery safer and more effective for patients with severe corneal problems caused by congenital aniridia.
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