Visual Outcome after Bilateral Implantation of Extended Depth of Focus Intraocular Lens in a Patient with Iris Microhemangiomas

Iris microhemangiomas (IMH) are acquired benign tumors of the iris stromal vasculature. We present the case of a 61-year-old diabetic woman with bilateral IMH and history of impaired pupillary response, in which excellent visual outcome was achieved after bilateral implantation of an extended depth of focus (EDOF) intraocular lens (IOL). On examination, her pupils demonstrated limited response to light and pharmacological mydriasis. There was history of spontaneous hyphema which resolved with medical therapy. She underwent uneventful bilateral phacoemulsification of visually significant cataracts, with implantation of an EDOF IOL in each eye. Post-operatively, the patient was satisfied with excellent uncorrected visual acuity both at distance and near. This case illustrates that EDOF IOLs can be a reasonable and effective option for cataract patients who suffer from iris pathology such as iris vascular anomalies and/or limited pupillary response.