Bilateral Implantation Of A New Non-Diffractive Extended Range-Of-Vision Toric Iol In A Young Patient With Alport Syndrome

We present the case of a 36-year-old patient with Alport syndrome who had also renal failure and hearing loss. The patient applied to our clinic with severe vision loss due to anterior lenticonus with posterior subcapsular cataract managed with bilateral implantation of an extended depth of focus toric intraocular lens (IOL) to achieve spectacle independence for both far and intermediate distances.

Bayındır Kavaklıdere Hospital, Ankara, Turkey.

The patient underwent phacoemulsification followed by implantation with the guidance of Callisto eye image-guided, markerless system (Carl Zeiss Meditec AG, Jena, Germany). DFT315 +19.00 D AcrySof IQ Vivity IOL (Alcon, Fort Worth, TX, USA) was implanted for right and DFT315 +19.00 D AcrySof IQ Vivity IOL for left eye. His refraction was -12.75 -6 x 3 for right eye and -13.75 -5.25 x 166 for the left eye. He had perimacular flecked retinopathy. Preoperatively, the uncorrected distance visual acuity (UDVA) was 0.7 logMAR, which improved to 0.1 logMAR in the right eye and from 0.8 logMAR to 0.1 logMAR in the left eye at 3 months postoperatively.Corneal astigmatism was 2.25 D for right and 2D for left eye. Refractive astigmatism was decreased 6 D to 0.75 D for right and 5 D to 0.75 D for left eye; postoperatively. Binocular distance corrected intermediate visual acuity (DCIVA) at 66 cm distance was 0.14 logMAR. The defocus curve demonstrated functional defocus of 2.0 diopters at 0.1 logMAR. The patient achieved complete spectacle independence at both far and intermediate distances without experiencing disturbing dysphotic phenomena, and no posterior capsule opacification was observed.

 Bilateral implantation of the Vivity toric IOL provided excellent distance and intermediate visual outcomes, functional near vision, absence of disturbing photic phenomena, complete spectacle independence for far and intermediate vision, and high patient satisfaction.