Toric Multifocal Intraocular Lens Implantation In A Patient With Bilateral Lens Subluxation

To report favorable clinical results following the implantation of toric multifocal intraocular lenses in a patient with bilateral lens subluxation.

Single medicle center of Taiwan

Case report

An 18-year-old female presented with chief complaints of decreased vision in both eyes since childhood. Upon ocular examination, her visual acuity measured 2/20 in the right eye and 2/30 in the left eye. Both corneas appeared clear without any opacity. Fundus dilated examination revealed the presence of nasal subluxation of the crystalline lens with the visible edge of the lens in both eyes, more prominant in the right eye where vitreous prolapse into the anterior chamber was observed. The patient denied family history of Marfan syndrome. Under the diagnosis of ectopia lentis, the patient was managed with capsular repair, phacoemulsification, and toric multifocal intraocular lens (MFIOL) implantation. 

The capsule was repaired with capsular tension segment (CTS) and capsular tension ring (CTR) with scleral fixation by flanged technique. MFIOL was implanted in the bag with good centration. The same procedure was done on the left side. Postoperatively, the patient had 20/20 vision in both eyes without correction. The near chart showed N8 vision in both eyes. There is no evidence of tilt, rotation, or decentration of the MFIOL in the follow-up visit.

Capsular repair with CTS and CTR by scleral fixation and implantation of premium IOL such as toric multifocal toric IOLs could be one of the treatment options for patients with subluxated lenses and restore both near and far vision.