scholarly journals Unilateral Multifocal Intraocular Lens Implantation in a Patient with Adie’s Pupil

2018 ◽  
Vol 9 (2) ◽  
pp. 369-374 ◽  
Author(s):  
Stephen A. LoBue ◽  
Fukutaro Mano ◽  
Erin Schaefer ◽  
Thomas D. LoBue
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Bilateral Cataract ◽  
Multifocal Iol ◽  
Pupillary Constriction ◽  
Lens Implantation ◽  
The Right ◽  
Bilateral Cataract Extraction

Purpose: To report a case of a patient with unilateral Adie’s pupil who underwent bilateral cataract extraction with multifocal and monofocal posterior chamber intraocular lens (IOL) implantation. Methods: A 74-year-old woman presented to our institution complaining of worsening near vision. Gross examination revealed a 6-mm fixed pupil on the right eye (OD) and a 5-mm pupil reacting to 3 mm with light on the left eye (OS). Slit lamp examination revealed a tonic pupil with an exaggerated pupillary constriction to dilute pilocarpine OD. Dilated exam revealed 2–3+ nuclear and cortical lens changes bilaterally. The patient’s active lifestyle, personality, and biometry measurements made her a good candidate for multifocal IOL (MfIOL) implantation OS. Femtosecond laser-assisted cataract extraction with a ReSTOR +3 ADD (SN60D1) implantation was performed OS. Monofocal lens implantation (SN60WF) was performed OD 6 months later. Results: One year postoperatively, our patient had an uncorrected visual acuity (VAsc) of 20/15 for distance and J10 for near OD. Her VAsc was 20/25 +1 for distance and J1 for near OS. Visual acuity when using both eyes was 20/15 for distance and J1 for near. Conclusion: Optimizing success for MfIOL implantation is a multifactorial process. Large pupils preoperatively are of particular concern, as this may lead to increased dysphotopsia with pupil-dependent MfIOLs. Thus, patients with unilateral mydriasis, such as Aide’s pupil, may have a beneficial outcome combining multifocal-monofocal implantation after bilateral cataract extraction, especially if they are not a candidate for monovision but desire spectacle independence.

scholarly journals Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract

2012 ◽  
Vol 1 (1) ◽  
pp. 66-67
Author(s):  
Irit Bahar ◽  
Omer Bialer
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Cataract Extraction ◽  
Senile Cataract ◽  
Posterior Chamber ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Lens Implantation ◽  
The Right

ABSTRACT We report cataract surgery with toric intraocular lens implantation for the management of senile cataract combined with pellucid marginal degeneration. A 72-year-old man with bilateral senile cataract and significant against-the-rule astigmatism sought counseling for blurry vision and glare, mostly in the right eye. Based on ophthalmic examination and corneal topography, a diagnosis of pellucid marginal degeneration and cataract was made. Since visual acuity and refraction had been stable in the past 3 years, the patient underwent cataract extraction and implantation of a custom-designed toric posterior chamber intraocular lens. Postoperative follow-up of 1.5-year demons- trated marked improvement in visual acuity, stable refraction and patient satisfaction. This treatment for pellucid marginal degeneration offers the simplicity of regular cataract surgery, and avoids the known complications of keratoplasty and other corneal surgical manipulation for the management of pellucid marginal degeneration. How to cite this article Bahar I, Bialer O. Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract. Int J Keratoco Ectatic Corneal Dis 2012;1(1):66-67.

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