{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:29:41Z","timestamp":1788406181005,"version":"build-2803163510"},"reference-count":5,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,22]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2019-232473","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T06:19:23Z","timestamp":1573453163000},"page":"e232473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Persistently poor vision in dim illumination after implantation of XtraFocus small-aperture IOL (Morcher)"],"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Edward","family":"Navon","sequence":"additional","affiliation":[{"name":"Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Subudhi","sequence":"additional","affiliation":[{"name":"Ruby Eye Hospital, Berhampur, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Mithal","sequence":"additional","affiliation":[{"name":"Ophthalmology, AlAhaliya Eye Care Center, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,10]]},"reference":[{"key":"2025082700340587000_12.11.e232473.1","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":"2025082700340587000_12.11.e232473.2","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":"2025082700340587000_12.11.e232473.3","doi-asserted-by":"publisher","DOI":"10.1364\/JOSAA.24.000578"},{"key":"2025082700340587000_12.11.e232473.4","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"},{"key":"2025082700340587000_12.11.e232473.5","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-228902","article-title":"Xtra focus pinhole IOL (Morchers GMBH) a novel approach to tackle irregular astigmatism and large pupillary defects with a single step surgery","volume":"12","author":"Agarwal","year":"2019","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:34:12Z","timestamp":1756280052000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":5,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,10]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bcr-2019-232473"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232473","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}