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Not an ideal patient for multifocal IOL implantation: case report

Poster Details

First Author: Y.Yildirim TURKEY

Co Author(s):    E. Duzgun   T. Kar   A. Cakir   S. Sagdic     

Abstract Details


Emphasise the importance of patient selection while planning cataract surgery with multifocal intraocular lens (IOL) implantation.


Gulhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey.


67-year-old female presented with low vision with a history of cataract surgery and multifocal IOL implantation two months ago in both eyes done by another medical center. She had a history of keratorefractive surgery 10 years ago because of high myopia and astigmatism. She expressed that she had had better vision before cataract surgery. She had centralized multifocal IOLs in both eyes. Her best corrected distance visual acuity was 20/400 in her right eye with +3.50(-3,00*110) correction and 20/100 in her left eye with +2.00(-6.00*85) correction. After a basic examination with retinoscopy, topography test was performed.


Topography showed irregular astigmatism evaluated as keratectasia in her both eye. Her visual acuity was 20/400 in right eye and 20/40 in left eye in potential acuity meter test. Fundus examination revealed tigroid retina with peripapillary atrophy and tilted disk. Macula was also atrophic in her right eye. We decided to exchange multifocal IOL in her left eye with a tree piece monofocal IOL. Toric IOL was not preferred because of irregular astgimatism. Postoperatively distance visual acuity of left eye increased to 20/50 with the +1.00 (-4.50*85) refractive error and near visual acuity was increased to J10 from J6.


In this case monofocal lens provided higher level of corrected distance and near vision and patient satisfaction than multifocal IOL. Ideal patient selection for new generation IOLs is the first step of this surgery for successful results.

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