Visual outcome after monocular implantation of extended depth of focus intraocular lens in a patient with iridodialysis: a case report and literature review
Bibliographic record
Abstract
BACKGROUND: Iridodialysis, the separation of the iris root from the ciliary body, typically results from trauma and can lead to significant visual impairment. This case report is novel as it demonstrates the successful management of iridodialysis using an extended depth of focus intraocular lens in a patient with a slightly irregular pupil. CASE PRESENTATION: A 34-year-old Hispanic man presented with reduced vision and pain in his right eye following blunt trauma from a nail at work. Examination revealed a small temporal corneal stromal scar, traumatic posterior subcapsular cataract, two inferior iridodialysis defects, and a superiorly displaced dyscoric oval pupil. Snellen uncorrected distance visual acuity was 20/400. The patient opted for an extended depth of focus intraocular lens implantation to meet his visual demands for distance and intermediate vision without glasses. Cataract surgery with capsular tension ring, extended depth of focus intraocular lens implantation, iridodialysis repair, and suture pupilloplasty were performed uneventfully. At 1 month postoperatively, uncorrected distance visual acuity improved to 20/40, while uncorrected intermediate visual acuity and uncorrected near visual acuity were 20/20. A central, relatively round, and slightly inferiorly peaked pupil was achieved. A steroid response intraocular pressure rise at postoperative month 2 required intraocular pressure-lowering medications, and symptomatic posterior capsular opacity developed at 8 months postoperatively. At 11 months postoperatively, selective laser trabeculoplasty and laser capsulotomy were performed. At 4-year follow-up, visual acuity measurements remained stable, and intraocular pressure was normal without any medication. The patient was satisfied with the visual and cosmetic outcomes. CONCLUSION: This case demonstrates that extended depth of focus intraocular lenses can be a viable option for patients with slightly irregular pupils following suture repair of the iris and pupil. The successful visual and cosmetic outcomes in this patient suggest that extended depth of focus intraocular lenses may be considered in similar complex cases, providing a balance of near, intermediate, and distance vision without significant visual disturbances.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".