PMC9428316_01
Timeline of the major surgical interventions in the patient's both eyes.
fmed-09-926792-g001.jpg
PMC9428316_01_fmed-09-926792-g001.jpg
F1
Hospital of Sichuan University on 13 July 2020 due to a gradual loss of visual acuity in the right eye over the previous 5 years. His left eye had undergone numerous surgical interventions due to postoperative complications, including IOL decentration, IOL dislocations, and retinal detachment (see Figure 1). On 18 July 2020 (Figure 1), an experienced surgeon (F.W.) performed a temporal clear corneal incision of 2.75 mm long with the patient under topical anesthesia, then instilled a viscoelastic agent (DisCoVisc, Alcon) to maintain normal anterior chamber depth. At 1 year after surgery (Figure 1), the uncorrected visual acuity was 20/25 in the right eye and 20/80 in the left eye, while intraocular pressure was 11.3 mmHg in the right eye and 14.6 mmHg in the left.
(A,B) Color photography of the right eye before surgery showed cataract and a significantly deepened anterior chamber. (C) Photographs of the right eyes by slit-lamp microscopy at 1 year after surgery at our hospital. The IOL was stably positioned in the eye. (D) Photographs of the left eyes by slit-lamp microscopy at 1 year after the right eye surgery at our hospital. The left iris pigment was dispersed. (E,F) Ultrasound biomicrographs of the right eye before (E) and after (F) surgery at our hospital. Panel (E) showed a deep anterior chamber and elongated zonular fibers. The panel (F) revealed the IOL to be centrally located in the eye after surgery. (G,H) Aberrometry using the iTrace system, showing visual quality in the right eye (G) and left eye (H) after right eye surgery at our hospital.
fmed-09-926792-g002.jpg
PMC9428316_01_fmed-09-926792-g002.jpg
F2
Slit lamp examination revealed unremarkable conjunctiva, an enlarged and clear cornea, a deepened anterior chamber in both eyes (Figure 2A), normal iris in the right eye but dispersion of iris pigment in the left eye, and an opaque lens in the right eye (Figure 2B). Ultrasound biomicroscopy showed that the anterior chamber of the right eye was deep, and the zonular fiber of the right eye was stretched (Figure 2E). In the right eye, the IOL was properly positioned and stable (Figure 2C), although the anterior chamber was 5.92 mm deep based on ultrasound biomicroscopy (Figure 2F). Technologies, Houston, TX, United States), berrometry indicated good visual quality in the right eye: the average height from the modulation transfer function curve was 0.720, and the Strehl ratio from the point spread function was 0.88970 (Figure 2G). The left eye appeared stable (Figure 2D), though it gave worse visual quality than the right eye based on aberrometry (Figure 2H).