Clinical management of nanophthalmos combined with cataract: a case series

Objectives: To explore the clinical characteristics, surgical challenges, and management strategies for nanophthalmos combined with cataract. Case presentation: We report three adult patients with nanophthalmos, all presenting with extremely short axial lengths (Case 1: OD 14.83 mm, OS 14.54 mm; Case 2: OD 16.27 mm; Case 3: OD 15.19 mm, OS 15.00 mm) complicated by varying degrees of cataracts and other ocular complications. All three patients underwent phacoemulsification cataract extraction with intraocular lens implantation following admission. Conclusion: Patients with nanophthalmos face higher risks during cataract surgery compared to the general population, with a greater likelihood of postoperative complications such as uveal effusion syndrome, choroidal detachment, and a fibrotic membrane on the anterior IOL surface. Thorough perioperative assessment, meticulous surgical technique, individualized complication management, and long-term follow-up are critical to improving outcomes.