"RINGS OF CLARITY, SHADOWS OF HAZE"

To highlight the visual and optical impact of posterior capsule opacification (PCO) developing after multifocal intraocular lens (IOL) implantation.

Tertiary Eye Centre Western India

A 57-year-old male, nine months post uncomplicated phacoemulsification with implantation of a diffractive multifocal IOL, presented with complaints of reduced visual clarity and contrast sensitivity. Slit-lamp examination and retroillumination imaging were performed to document the findings.Slit-lamp retroillumination revealed central dense fibrotic PCO with peripheral fibrosis, distinctly visible against the concentric diffractive rings of the multifocal optic. The monochromatic image demonstrates the interaction between the optical design and secondary capsular changes affecting image quality.

This image underscores the importance of regular postoperative evaluation in multifocal IOL patients, as PCO can significantly degrade visual performance. Early recognition and timely Nd:YAG capsulotomy are essential to restore optimal multifocal function and patient satisfaction.