Bilateral sequential implantation of a monofocal IOL and a pseudophakic sulcus-placed trifocal IOL in a young adult with posterior microphthalmos

摘要

An 18-year-old man enquired about the possibility of refractive surgery due to increasing difficulty performing near tasks. Corrected distance visual acuity was 20/25 with +10.00 ?1.00 ×40 degrees right eye and 20/25 with +11.00 ?1.00 ×120 degrees left eye. Corrected near visual acuity was Jaeger (J) 4. Optical biometry and corneal tomography revealed posterior microphthalmos with estimated intraocular lens (IOL) power >45.0 diopters (D) right eye and >47.0 D left eye. Considering the normal anterior segment morphology and the patient's high motivation for improving refractive error, refractive lens exchange was performed with monofocal +45.0 D IOLs. The residual refractive error was corrected by secondary bilateral implantation of a supplementary sulcus-placed trifocal IOL. One week after the second implant, uncorrected distance visual acuity was 20/25 right eye and 20/30 left eye, whereas the uncorrected near visual acuity improved to J2. Visual stability was verified at the third postoperative month with a residual refractive error of ?0.50 × 120 degrees right eye and +1.50 ?1.25 ×150 left eye.