A case report of Implantable Collamer Lens removal with cataract extraction and TECNIS Symfony extended range of vision intraocular lens (ZXR00) implantation

Abstract

Abstract Background One of the most common reasons for patients to have a second operation to remove the implantable collamer lens (ICL) is anterior subcapsular cataract (ASC), which is also one of the major problems following ICL implantation. Nonetheless, it is still unclear if patients with high myopia can benefit from contemporaneous ICL removal, cataract extraction and multifocal intraocular lens (MIOL) implantation in terms of their visual outcomes. Case presentation A 39-year-old male highly myopic patient who underwent concurrent ICL removal, cataract extraction, and TECNIS Symfony ZXR00 IOL implantation in both eyes is reported in this case. Surgeons organize the surgery taking into account the patient's strong desire for freedom from spectacles, the needs for everyday vision, and the features of the chosen IOL. Enhanced biological measurement devices, such us Pentacam and IOL Master 700, were used to get accurate parameters. The IOL power was calculated using the Barrett True-K formula, thereby allowing a residual refraction of -0.50D to -0.75D to match patient’s demand. The surgeries were performed on the right and left eyes with a 2-week interval. A comprehensive evaluation of the patient's visual outcomes was conducted at the 3-month follow-up using manifest refraction, anterior segment OCT (Casia2), defocus curve, OPD-Scan III, and NEI-VFQ-14. The patient demonstrated excellent near and intermediate vision as well as overall visual quality, with high satisfaction. Conclusion For patients with ASC requiring surgery after ICL implantation, and with a strong desire for spectacle independence and specific occupational demands, the use of TECNIS Symfony ZXR00 IOL, along with adjustments to the residual refractive power, may result in outstanding visual quality and patient satisfaction.