Rotationally asymmetric multifocal IOL implantation in acquired nystagmus with spectacle and contact lens intolerance.

PURPOSE: To describe a case of refractive lens exchange with multifocal intraocular lens implantation in a 52-year-old woman with emmetropic presbyopia who had near glasses and contact lens intolerance after acquired nystagmus.

METHODS

Preoperative corrected distance visual acuity was 20/25 in the right eye, 20/20 in the left eye, and 20/20 binocularly. Corrected near visual acuity was 20/30 in the right eye and 20/20 in the left eye, reaching 20/20 binocularly but showing unsatisfactory binocular vision with asthenopia and intolerance to prolonged reading. The surgical plan entailed bilateral implantation of multifocal intraocular lens.

RESULTS

Three months postoperatively, uncorrected distance visual acuity was 20/20 in the right eye and 20/20 in the left eye, reaching 20/20 binocularly. Monocular and binocular uncorrected near visual acuity of 20/20 was achieved without symptoms of asthenopia in prolonged reading. There were no changes in nystagmus characteristics after surgery.

CONCLUSIONS

Multifocal intraocular lens implantation to manage a case of clinically significant acquired nystagmus may be a safe alternative, especially if others options have failed.