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This abstract is assigned to session AOB Free Papers 2

Presentation type	Oral presentation
Title	Bag In the Lens (BIL) procedure for early cataract in an adult patient with Branchio-Oculo-Facial syndrome (BOFS)

Purpose	To report a surgical case of bag-in-the-lens (BIL) procedure for early cataract in an adult patient with branchio-oculo-facial syndrome.
Methods	A 35-year-old male with Branchio-Oculo-Facial syndrome (BOFS) was referred for predominantly unilateral gradual decrease in visual acuity in the right eye. Upon examination, bilateral cataract was diagnosed. The patient underwent a unilateral BIL procedure for cataract in the right eye under general anesthesia. Peri- and intraoperatively, special considerations were made due to the ocular comorbidities associated with BOFS, including the presence of iridal and chorioretinal coloboma.
Results	The lens was successfully removed by phacoemulsification and the intra-ocular lens (IOL) was implanted after anterior and posterior rhexis. Intra-operatively zonular instability was observed, and lens prolapse occurred. Furthermore, anterior vitrectomy was performed on fibrotic anterior hyaloid, which was indicative of vitreopathy. Post-operatively, significant corneal edema was noted but had gradually resolved by the one-month follow-up. At this last available follow-up, the best-corrected visual acuity improved from 6/126 preoperatively to 6/60, and the patient reported enhanced color vision.
Conclusion	Early cataract is one of the ocular manifestations in BOFS. Careful considerations and intraoperative management are needed to address anatomical ocular challenges associated with BOFS. This case emphasizes the feasibility and benefits of cataract surgery in this rare condition, guiding clinicians in the management of similar cases.
Conflict of interest	No

Authors 1

Last name	SEDER
Initials	A
Department	Department of Ophthalmology, University Hospital of Brussels, Brussels, Belgium
City	Brussels, Belgium

Authors 2

Last name	Nì Dhubhghaill
Initials	S
Department	Department of Ophthalmology, University Hospital of Brussels, Brussels, Belgium
City	Brussels, Belgium