Edof Iol Implantation In A Patient With Asteroid Hyalosis: A Case Report

Published 2025 - 43rd Congress of the ESCRS

Reference: PO052 | Type: Case Report | DOI: 10.82333/5mn6-3224

Authors: Hams Samy* ¹ , Noha Fawky ² , Omar Ayman ³ , Menna Kamel ⁴ , Ahmed assaf ⁵

¹Watany Eye Hospital,Cairo,Egypt;Assaf Center,Cairo,Egypt, ²Cairo,Watany Eye Hospital,Egypt,Egypt;Assaf Center,Cairo,Egypt, ³Cairo,Ain Shams University,Egypt,Egypt;Assaf Center,Cairo,Egypt, ⁴Cairo,Ain Shams University,Egypt,Egypt;Cairo,Assaf Center,Cairo,Egypt, ⁵Cairo,Watany Eye Hospital,Egypt,Egypt;Ain Shams University,Cairo,Egypt;Assaf Center,Cairo,Egypt

Purpose

To report the visual outcomes after bilateral implantation of non-diffractive extended depth of focus IOL in a patient with bilateral asteroid hyalosis

Setting

Case Study at Watany Eye Hospital and Assaf Center

Report of case

A 50-year-old female sought refractive surgery for spectacle independence. Preoperative CDVA was 20/32, 20/25 OD and OS respectively (-3.75D-1.0D x 35 OD, -3.75D-0.50D x 60 OS). Examination revealed grade 2 posterior subcapsular cataracts and significant asteroid hyalosis, denser in the right eye. Comprehensive pre-op evaluation included wavefront aberrometry, corneal tomography/topography, and macular OCT. After detailed discussion, a non-diffractive EDOF IOL (AcrySof® IQ Vivity™, Alcon, Fort Worth, Texas, USA) was chosen, acknowledging potential visual quality impacts from asteroid hyalosis and the possibility of IOL explantation. Sequential, uneventful phacoemulsification was performed. Postoperatively, UDVA was 20/25 OU. Binocular UIVA was 20/32, and UNVA was 20/40, respectively. One-month follow-up confirmed good IOL centration. Athough Asteroid hyalosis could be detected with high resolution pyramidal wavefront aberrometry, ocular wavefront analysis were comparable to eyes without asteroid hyalosis, and subjective visual outcomes were satisfactory.

Conclusion/Take home message

Utilizing extended depth of focus (EDOF) intraocular lenses (IOLs) in patients with asteroid hyalosis is feasible with thorough preoperative assessment. Crucial for successful outcomes are meticulous evaluation of potential optical quality effects and realistic patient expectation management. Further research is warranted to elucidate the precise impact of asteroid hyalosis on the complex wavefront shaping and stretching induced by the EDOF IOL.