IMPLANTATION OF A CUSTOM MADE SCLERAL FIXATED EXTENDED DEPTH OF FOCUS (EDOF) INTRAOCULAR LENS (IOL) IN APHAKIA

To present a case of aphakia due to lens dislocation managed with with pars plana vitrectomy (PPV), lens fragmentation, and implantation of a custom Extended Depth of Focus (EDOF) scleral fixated intraocular lens (IOL) for optimized visual outcomes.

First Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital of Athens

A 68-year-old female patient presented with vision loss in her right eye following blunt trauma, leading to aphakia and a dropped nucleus in the vitreous cavity. Preoperative assessments included optical biometry, corneal topography, and refractive measurements to determine precise IOL power. Surgical intervention included PPV, lens fragmentation, and implantation of a custom-made EDOF scleral fixated IOL. The patient requested independence from glasses, guiding the selection of an EDOF lens.

Three months postoperatively, the patient achieved excellent uncorrected distance visual acuity (UDVA) of 20/23, good intermediate vision at 20/29, and near vision at 20/40 without the need for corrective lenses. The postoperative examination revealed a stable IOL position with no signs of inflammation or other complications. The patient reported high satisfaction with her visual outcome, experiencing smooth vision across various distances without dysphotopic symptoms such as glare or halos. 

The combination of scleral fixation and EDOF IOL technology in cases of aphakia and lack of capsular support offers a promising solution for patients desiring a broad visual range without spectacles. This is the first documented case reporting the implantation of a custom-made EDOF scleral-fixated IOL, demonstrating that such lenses can successfully provide high-quality vision across multiple distances. This approach offers an improved quality of life for patients with high visual demands. Further studies should occur in order  to detect potential side effects or complications involved in the insertion of this premium IOL and with performing a PPV.