Supplementary Material for: Femtosecond LASER-Assisted Double Intraocular Lens Exchange in Nanophthalmic Eyes

Introduction: Though patients with nanophthalmos frequently endure decreased quality of vision with contact lenses or spectacles, refractive surgery is generally an inadequate alternative due to the associated high refractive error. A refractive lens exchange (RLE) is an alternative option but is technically challenging, requiring accuracy in biometry measurements and procedures. Case Presentation: This case discusses a 27-year-old female with nanophthalmos (axial lengths 17.6 mm and 17.4 mm, right and left eyes, respectively) who underwent a femtosecond laser-assisted (FLA) RLE with simultaneous implantation of a monofocal and a Sulcoflex trifocal (Rayner, Britain) lens in each eye. Preoperative cycloplegic refraction was +11.50/−0.75 × 145 and +12.00/−1.00 × 35 in the RE and LE, respectively. Best-corrected visual acuity (BCVA) at distance and near in the RE and LE was 6/7.5 and J1, 6/8.5 and J2, respectively. Uncorrected visual acuity (UCVA) was >6/120 and >J14 for each eye. FLA RLE was performed in the RE, then in the LE 2 weeks later. In each eye, a monofocal (44.0 D, RE, and LE) and a Sulcoflex trifocal lens (both implants, Rayner, Britain) were implanted in one procedure. Distance and near UCVA measured 6 weeks post-op RE and 1-month post-op LE at 6/8.5 and J1 in the RE, 6/10 and J1 in the LE. The RE and LE refraction and BCVA were +0.50/−1.00 × 115, 6/7.5, and plano/−1.00 × 55, 6/8.5, respectively. The post-op outcomes were uneventful. Conclusion: A single procedure concurrently implanting a monofocal and Sulcoflex trifocal intraocular lens in nanophthalmic eyes resulted in an excellent UCVA. This procedure can be considered esthetic and reconstructive as it significantly improves patient appearance and function.

引言：尽管纳米眼患者常常因佩戴隐形眼镜或眼镜而遭受视力质量下降，但由于伴随的高度屈光误差，屈光手术通常并非一个充分的替代方案。屈光晶体置换术（RLE）是一种替代方案，但其在技术上极具挑战性，需要精确的生物测量值和手术操作。病例介绍：本病例讨论了一位27岁女性纳米眼患者（左右眼轴长度分别为17.6毫米和17.4毫米）接受了飞秒激光辅助（FLA）RLE手术，并在每只眼睛同时植入了一只单焦和一只Sulcoflex三焦点（Rayner，英国）晶体。术前散瞳验光结果分别为右眼+11.50/−0.75 × 145和左眼+12.00/−1.00 × 35。在右眼和左眼，最佳矫正视力（BCVA）分别为6/7.5和J1，6/8.5和J2。未矫正视力（UCVA）均大于6/120和大于J14。FLA RLE首先在右眼进行，然后在2周后的左眼进行。在每只眼睛中，通过一次手术植入了一只单焦晶体（右眼44.0 D，左眼同样为44.0 D）和一只Sulcoflex三焦点晶体（两处植入，Rayner，英国）。术后6周右眼和1个月后左眼的远距和近距UCVA分别为6/8.5和J1，6/10和J1。右眼和左眼的验光和BCVA分别为+0.50/−1.00 × 115，6/7.5，以及平光/−1.00 × 55，6/8.5。术后结果平稳。结论：在一次手术中同时植入单焦和Sulcoflex三焦点人工晶体的纳米眼，实现了卓越的未矫正视力。该手术既美观又具有重建性，因为它显著提高了患者的外观和功能。