Bilateral Secondary Cataract After Previously Performed Multifocal Phakic Intraocular Lens Implantation Into Post-Lasik Eyes.

To report the bilateral cataract surgery secondary to multifocal phakic IOL lenses implantation into post-LASIK eyes.

Patient was consulted in The dr Solomatin eye clinic, Riga, Latvia. All previously performed surgical procedures were performed in other clinical practices that are not associated with the dr Solomatin eye clinic.

The female 48 YO was consulted due to complaints about vision acuity deterioration, both distant and nearvision. There was a LASIK surgery performed uneventfully on both eyes 10-15 years ago in another clinic. Subsequently, presbyopia symptoms started to develop and around 2 years ago patient has visited the refractive surgeon practice where the multifocal phakic IOL was offered as a method of choice to correct the presbyopia. According to a patient, the surgery was performed uneventfully. However, focusing problems got worse immediately after the surgery. It was explained as an adaptation period, and the patient was instructed to wait for 6-12 month for stabilization to develop, that never happened. Since the surgery was performed on the medical tourism basis, and a follow-up visit was impossible to organize due to travel restrictions,  the patient decided to arrange a consultation in The dr. Solomatin eye clinic. During the consultaion, BCVA OD 0.3 cc -1.00 d sph =0.5; OS 0.4 cc -1.00 d sph cum -0.75 d cyl ax 35=0.5. Phakic IOL were positioned in the ciliary sulcus. The central cataract was diagnosed in both eyes. Some retinal perifperical degeneration lesions, limited with lasercoagulation were found. The pIOL extraction with simultaneous femtosecond-laser assisted cataract surgery and EDOF IOL implantation is planned on both eyes. IOL was calculated using IOL Master 700 Barret II formula for post-myopic LVC and ASCRS calculator. The surgery is planned for April-May 2023.

Special care and regular follow-up examinations, including the anterior OCT to monitor the postoperative vault of the phakic IOL is important after the surgery involving the phakic IOL implantaion.