Vitrectomy For Epiretinal Membrane Removal Combined With Lens Replacement Using A New Implant With Spiral Optics For Full Range Vision
Published 2026 - 44th Congress of the ESCRS
Reference: POREF004 | Type: Case Report | DOI: 10.82333/y4x4-w958
Authors: Mr Zia Carrim* 1 , Raawiyah Mohamudally 2 , Abdullah Munglah 2
1Cataract and Retina Service,The Eye Clinic,Port Louis,Mauritius;Ophthalmology,Leeds Teaching Hospitals NHS Trust,Leeds,United Kingdom, 2The Eye Clinic,Port Louis,Mauritius
Purpose
To describe the rationale and outcome of implanting a non-diffractive spiral optic full-range intraocular lens (IOL) in an eye with cataract and co-existing epiretinal membrane (ERM).
Setting
Single retrospective case report from a specialised cataract and vitreoretinal service in Mauritius.
Report of case
A 73-year-old woman presented for a second opinion following uneventful right cataract surgery with monofocal IOL implantation. Postoperative unaided visual acuity (UDVA) was LogMAR 0.18, but she was dissatisfied with spectacle dependence for near tasks and suboptimal distance vision.
Her left eye had cataract (BCVA LogMAR 0.28; +1.25/+2.00×1) and a mild epiretinal membrane with foveal distortion. Corneal topography demonstrated regular astigmatism and higher-order aberrations <0.30 µm. The right eye was dominant and structurally healthy.
Management options discussed included monovision strategies and bilateral full-range correction. The relative contraindication of multifocal optics in the presence of macular pathology was explained. Given the patient’s desire for spectacle independence and reluctance for further surgery in the dominant eye, combined phacoemulsification and pars plana vitrectomy with membrane peel was undertaken in the left eye with implantation of a non-diffractive, spiral optic, toric, full-range IOL. Postoperatively, UDVA was 0.06 logMAR and unaided near vision was 0.30 logMAR with a refraction of –0.75/+0.50×16. At 2 and 6 weeks, the patient reported functional spectacle independence for daily activities.
Conclusion/Take home message
Macular pathology is commonly regarded as a contraindication to multifocal IOL implantation. This case suggests that, in selected patients with mild ERM undergoing membrane peel, full-range IOL implantation may be considered following careful counselling and management of expectations. Rather than absolute exclusion, individualised risk–benefit assessment may broaden treatment possibilities in appropriately selected cases.