Bilateral Toric Multifocal Intraocular Lens Implantation In A Patient With Lens Subluxation: A Case Report On Surgical Management And Visual Outcomes

To report the clinical outcomes and surgical management of bilateral lens subluxation treated with Toric Multifocal Intraocular Lens implantation and capsular stabilization.

case report

An 18-year-old female presented with a long-standing decrease in vision in both eyes. Upon ocular examination, her Uncorrected Visual Acuity was $2/20$ in the right eye and $2/30$ in the left eye. Corneal examination revealed clear media without opacities in both eyes. Fundus examination under dilation showed nasal subluxation of the crystalline lens with visible lens edges bilaterally. The subluxation was more pronounced in the right eye, accompanied by vitreous prolapse into the anterior chamber. The patient reported no family history of Marfan syndrome.

Diagnosed with Ectopia Lentis, the patient received surgical management including capsular stabilization, phacoemulsification, and Toric Multifocal Intraocular Lens implantation. The capsular bag was secured using a Capsular Tension Segment and a Capsular Tension Ring via scleral fixation with the flanged technique.The Toric Multifocal Intraocular Lens was positioned with excellent centration.
Postoperatively, the patient achieved an Uncorrected Distance Visual Acuity of 20/20 and a Near Visual Acuity of N5 bilaterally. Follow-up showed no tilt, rotation, or decentration of the intraocular lenses, confirming successful restoration of a full range of vision despite significant lens instability.

Capsular stabilization using a Capsular Tension Segment and Capsular Tension Ring with scleral fixation is an effective strategy for managing subluxated lenses. This approach allows for the safe implantation of premium lenses, such as Toric Multifocal Intraocular Lenses, which can successfully restore a full range of near and distance vision in patients with lens instability.