ESCRS - P049 - RARE INDICATION FOR INTRAOCULAR LENS EXCHANGE

RARE INDICATION FOR INTRAOCULAR LENS EXCHANGE

Published 2022 - 26th ESCRS Winter Meeting

Reference: P049 | Type: Abstracts | DOI: 10.82333/2ykn-8209

Authors: Andrada-Elena Mirescu* 1 , Ioana Teodora Tofolean 2 , George Balta 3 , Florian Balta 2

1Ophthalmology Department,Clinical Ophthalmology Emergency Hospital,Bucharest,Romania;Ophthalmology Department,"Ovidius" University of Medicine,Constanta,Romania, 2Ophthalmology Department,Retina Clinic,Bucharest,Romania;Ophthalmology Department,"Carol Davila" University of Medicine and Pharmacy,Bucharest,Romania, 3Ophthalmology Department,Clinical Ophthalmology Emergency Hospital,Bucharest,Romania

Purpose

The current paper emphasizes on the case of a healthy young adult who was implanted a premium trifocal IOL. Six months later, in spite of the excellent refractive outcome, the patient’s vision was not satisfactory. Therefore, the first IOL was exchanged with another premium model, with better visual performance.

Setting

A 38 year-old young male underwent cataract surgery and was implanted a ZEISS AT LISA trifocal intraocular lens. 6-months postoperatively, the best corrected visual acuity was 0.4 for both near and far vision, despite the good lens centration and the neglectable residual refraction (minus 0.25 cylinder diopters at 160 degrees). 

Methods

After excluding any associated ophthalmic condition, considering the possibility of persistent lack of neural adaptation, we proceeded with the IOL exchange. Under viscoelastic protection, the IOL was carefully removed from the capsular bag and extracted from the eye by using the bisection technique. A premium hybrid EDOF IOL (EDEN, Swiss Advanced Vision) was implanted in the bag, with no capsular damage. No anterior or pars plana vitrectomy were needed during the exchange procedure.

Results

Postoperatively, both distance and near best corrected visual acuity significantly improved to 0.8, there was a minor myopic and astigmatic residual refractive error and the patient experienced an overall better quality of vision, with no visual disturbances. 

Conclusion

Intraocular lens exchange, an unusual procedure, has specific indications, such as: in-the-bag or out-of-the bag subluxation, intraocular inflammation, selected cases with residual refractive errors, visual disturbances (such as halos and glare) and persistent lack of neural adaptation.

Multifocal IOLs require significant neural adaptation. The lack of it may conduct to unsatisfied patients and further interventions.