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To document the visual outcome and efficacy of sulcus positioned extra focus pinhole IOL (Morchers GMBH) in a case of traumatic mydriasis with full 8.0 mm dilated pupil and irregular astigmatism post cataract surgery.
28 year old young male patient ,history of cataract surgery in left eye for traumatic cataract elsewhere 3 years back with traumatic mydriasis and single piece intraocular lens in the bag. Preoperative pupil measurement was 7.0 mm. xtra focus pinhole IOL was implanted in sulcus having a pinhole aperture of 1.36 mm.
left eye preoperative uncorrected distance visual acuity was 20/150. intermediate visual acuity was 20/100. and uncorrected near visual acuity wasJ10 preoperative total corneal higher-order aberrations were 3.30 microns in left eye. total corneal coma was 0.97 µ. right eye was normal, 20/20. postoperative left eye uncorrected distance distance visual acuity was20/25 intermediate uncorrected visual acuity was 20/25. and uncorrected near visual acuity was J3. binocular uncorrected distance visual acuity was 20/20. binocular intermediate uncorrected visual acuity was 20/20. and binocular near uncorrected visual acuity was J1 . postoperatively the glare and photophobia resolved completely. subjectively patient was satisfied with the visual outcomes.
Pinhole IOLs are an exciting armamentarium in cases of irregular astigmatism irregular and mydriatic pupils. They increase the depth of focus thereby giving a reasonably good visual acuity for distance intermediate and near.