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Case report
Persistently poor vision in dim illumination after implantation of XtraFocus small-aperture IOL (Morcher)
  1. Prateek Agarwal1,
  2. Samuel Edward Navon1,
  3. Praveen Subudhi2 and
  4. Neha Mithal3
  1. 1 Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
  2. 2 Ruby Eye Hospital, Berhampur, Odisha, India
  3. 3 Ophthalmology, AlAhaliya Eye Care Center, Abu Dhabi, United Arab Emirates
  1. Correspondence to Dr Prateek Agarwal; dr.prateekagarwal{at}


A 21-year-old patient presents to us with complaints of blurred vision and photophobia in the left eye, with an uncorrected visual acuity of 20/100 improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction, with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye. One week postoperatively, the left eye uncorrected visual acuity improved to 20/30, uncorrected intermediate visual acuity improved to 20/40, and uncorrected near visual acuity improved to J4. The glare and photophobia resolved completely. Surprisingly, the patient complained of severely poor vision in dim illumination. His vision was limited to bare perception of objects and hand movements close to the face. He started facing difficulties in major activities such as driving at night and in dark ambient surroundings such as movie theatres, which persisted to the extent of necessitating explantation of the implant.

  • ophthalmology
  • Pupil
  • Iris
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  • Contributors PA: prime surgeon and analysis of data. NM: analysis and interpretation of data, along with the design of the manuscript. SEN: concept of the manuscript and its layout. PS: modifications in the text, language and take home message.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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