Posters

Morcher XtraFocus Pinhole implant: a glaringly obvious solution in a novel context

Poster Details

First Author: N.Mirza UK

Co Author(s): O. Stewart                    

Abstract Details

Purpose:

Suboptimal cataract surgery outcomes in patients with previous radial keratotomy inspired the development of the Morcher XtraFocus pinhole implant.  Current indications also include irregular corneal astigmatism secondary to keratoconus and penetrating keratoplasty (PKP).  The implant combines the advantages of the pinhole effect and the widespread practice of piggyback lens implantation.   We provide an overview of this dynamic implant and report a novel use in a case of ocular albinism where the patient experienced intolerable glare due to iris transillumination.

Setting:

Hull Royal Infirmary, UK

Methods:

Uncomplicated sequential phacoemulsification and intra-ocular lens implantation was performed in a patient with ocular albinism with bilateral diffuse iris transillumination.  Visual acuity improved from 6/36 to 6/18 and 6/24 to 6/18 in the right and left eyes respectively.  The patient reported their pre-existing glare symptoms had worsened post-operatively.  Coloured contact lenses were utilised for a year before the patient became contact lens intolerant.  The patient presented fourteen years post-operatively; reporting significant glare symptoms, especially in sunlight.  The patient was offered and underwent uncomplicated secondary piggyback Xtrafocus pinhole implantation.

Results:

On review one month post-operatively, the patient reported a dramatic reduction in glare symptoms and requested surgery on the fellow eye.  A gain of one line of Snellen acuity was achieved.  The implant was positioned in the ciliary sulcus and intra-ocular pressure was within normal limits.  There were no post-operative complications.

Conclusions:

The presented case adds to the growing body of evidence that the Morcher XtraFocus pinhole implant is a safe and effective means of addressing troublesome visual symptoms.  Furthermore, we propose the implant can be considered in the management of iris transillumination defects that produce excessive glare symptoms in pseudophakic patients.  Advantages of the implant include its use by means of an established surgical technique, its potential reversibility and ability to permit visualisation of the posterior segment of the eye using infra-red imaging.

Financial Disclosure:

None