A clinical case of implantation of a customized toric multifocal IOL Lentis Mplus LU-313T

Abstract

Background. Modern cataract surgery requires increasingly high standards to achieve excellent visual outcomes at all distances, with mandatory intraoperative correction of corneal astigmatism. In such cases, customized intraocular lenses (IOLs), calculated according to the patient’s specific biometric parameters, are used. This report presents a clinical case of implanting a customized toric multifocal IOL during cataract surgery in a patient with high axial myopia and concomitant corneal astigmatism. Case description. A 45-year-old male with complicated cataract, high axial myopia, and corneal astigmatism underwent phacoemulsification with implantation of a customized multifocal IOL (Lentis Mplus LU-313T). In addition to standard ophthalmological examinations, optical specular endothelial microscopy of the cornea, optical coherence tomography (OCT) of the retina, and Scheimpflug corneal densitometry were performed. Preoperative IOL power calculation was carried out using an online calculator based on IOLMaster and corneal topography data. Postoperatively, uncorrected visual acuity was 1.0 for distance, 0.4 at intermediate, and 0.5 at near. Discussion. Implantation of customized IOLs with rotationally asymmetric optics, with a +2.0 D addition in the dominant right eye (Lentis Mplus LU-313 MF-20T) and a +3.0 D addition in the nondominant left eye (Lentis Mplus LU-313 MF-30TX), eliminated the need for postoperative optical correction at different distances. High uncorrected visual acuity was achieved for distance, intermediate, and near vision. The absence of halo effect after surgery enabled the patient to drive comfortably, including in the evening and at night. Conclusion. This comprehensive surgical approach to treating complicated cataract in eyes with high myopia and corneal astigmatism provided complete visual rehabilitation and eliminated the need for additional optical correction.