{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:44:06Z","timestamp":1759963446594,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,9]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>A 69-year-old patient presented to us with traumatic mydriasis with irregular pupil measuring 7\u2009mm, with superior loss of iris tissue and large inferior peripheral iridotomy and pseudophakia. The patient had history of blunt trauma 3 years ago in a fire cracker injury. He was operated elsewhere primarily after the trauma for cataract surgery with intraocular lens implantation and had suboptimal visual outcome with glare and photophobia. He presented to us with irregular pupil and inferior iridectomy with pseudophakia. The uncorrected visual acuity was 20\/150 improving to 20\/50 with glasses. He had a history of cataract surgery with intraocular lens (IOL) implantation done elsewhere several years back. The patient was not a diabetic or hypertensive. There was a para central corneal scar causing irregular corneal astigmatism. Extra focus pinhole IOL was implanted in sulcus having a pinhole aperture 1.36\u2009mm. Preoperative total corneal higher-order aberrations were 3.3 \u00b5 and total corneal coma was 0.97 \u00b5. Postoperatively uncorrected distance visual acuity improved to 20\/40 intermediate uncorrected visual acuity improved to 20\/30 and uncorrected near visual acuity was J3.<\/jats:p>","DOI":"10.1136\/bcr-2018-228902","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T04:33:22Z","timestamp":1554352402000},"page":"e228902","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Xtra focus pinhole IOL (Morchers GMBH) a novel approach to tackle irregular astigmatism and large pupillary defects with a single step surgery"],"prefix":"10.1136","volume":"12","author":[{"given":"Prateek","family":"Agarwal","sequence":"first","affiliation":[{"name":"Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel Edward","family":"Navon","sequence":"additional","affiliation":[{"name":"Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"key":"2025082702271320000_12.4.e228902.1","first-page":"59","article-title":"Aberrations of the eye and their effects on vision: 1. Spherical aberration","volume":"20","author":"Jenkins","year":"1963","journal-title":"Br J Physiol Opt"},{"key":"2025082702271320000_12.4.e228902.2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/ICO.0000000000000647","article-title":"Irregular astigmatism after corneal transplantation--efficacy and safety of topography-guided treatment","volume":"35","author":"La\u00edns","year":"2016","journal-title":"Cornea"},{"key":"2025082702271320000_12.4.e228902.3","doi-asserted-by":"crossref","first-page":"506","DOI":"10.5301\/ejo.5000922","article-title":"Single-pass four-throw technique for pupilloplasty","volume":"27","author":"Narang","year":"2017","journal-title":"Eur J Ophthalmol"},{"key":"2025082702271320000_12.4.e228902.4","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jcrs.2017.06.003","article-title":"Artificial iris implantation in various iris defects and lens conditions","volume":"43","author":"Mayer","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"2025082702271320000_12.4.e228902.5","doi-asserted-by":"publisher","DOI":"10.1364\/JOSAA.24.000578"},{"key":"2025082702271320000_12.4.e228902.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)90005-2"},{"key":"2025082702271320000_12.4.e228902.7","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1097\/ICO.0000000000000506","article-title":"Supplementary, sulcus-fixated intraocular lens in the treatment of spherical and astigmatic refractive errors in Pseudophakic Eyes After Keratoplasty","volume":"34","author":"Meyer","year":"2015","journal-title":"Cornea"},{"key":"2025082702271320000_12.4.e228902.8","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.jcrs.2017.09.014","article-title":"New pinhole sulcus implant for the correction of irregular corneal astigmatism","volume":"43","author":"Trindade","year":"2017","journal-title":"J Cataract Refract Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:27:22Z","timestamp":1756286842000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,3]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bcr-2018-228902"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228902","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}