Background: Here we report the case of a patient who underwent vitreous surgery because of a complaint of intense waxy vision following diffractive multifocal intraocular lens (IOL) implantation and for whom removal of the vitreous opacity resulted in a dramatic improvement in symptoms.
Case presentation: A 60-year-old man presented with a chief complaint of decreased visual acuity in the left eye. Bilateral cataracts that were more severe in the left eye were noted;therefore, cataract surgery was performed using multifocal IOLs for both eyes. Postoperatively, the patient continued to complain of waxy vision in the left eye;although the IOL was changed to a single-focus IOL, the symptoms did not improve. Because he suddenly developed the same waxy visionin the right eye that had been seen in the left eye, for which he had expressed no dissatisfaction up until this point despite having the same refractive multifocal IOL implanted, we felt that the cause of the waxy vision might be vitreous opacity accompanying posterior vitreous detachment. Performing bilateral vitreous surgery resulted in dramatic improvements in the patient's symptoms and contrast sensitivity.
Conclusions: In our patient, we speculate that decreased contrast sensitivity resulting from diffractive multifocal IOL implantation was influenced by vitreous opacity accompanying posterior vitreous detachment, causing a further decrease in contrast sensitivity and strong dissatisfaction. This case suggests the importance of measuring contrast sensitivity and observing symptoms of vitreous opacity not only before multifocal IOL implantation but also postoperatively.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 306-311, 2018.