{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T15:10:07Z","timestamp":1751641807593,"version":"3.41.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Extreme axial eyeball length is a known risk factor for decreased accuracy of intraocular lens calculations. We report a case of a 35 years-old male with anisometropic amblyopia and an axial length of 35.7 mm in his right eye. To the best of our knowledge, this is a case of one of the longest eyeballs ever scientifically reported. The patient presented with presenile cataracts in the right eye, hand movement visual acuity, and required cataract surgery. Due to his high anisometropia, he was unable to wear spectacle correction prior to surgery in the amblyopic eye. The left (non-amblyopic) eye had moderate myopia and corrected to 20\/20 with no signs of cataracts. Various intraocular lens (IOL) calculations were compared, aiming for a slight postoperative residual myopia in the right eye (approx. \u22121.50 D). The patient required a minus-power intraocular lens, and an IOL with a larger overall diameter (model 92S \u201cBigfoot IOL\u201d manufactured by Morcher GmbH, Stuttgart, Germany) was selected. On the last available visit at 6 months, his refractive error was \u22121.50 to \u22120.75 D \u00d7 179\u00b0 with a corrected visual acuity of 20\/63. The large IOL was stable in the capsular bag, and there were no postoperative complications. The patient was able to wear spectacles with correction in both eyes and reported significant improvement in binocular vision and quality of life. Negative power IOLs typically have different optic configurations and require special considerations during IOL calculation. Care should be taken to avoid postoperative hyperopic refractive error. Nowadays, surgeons can choose from a selection of traditional formulas, newer-generation formulas, and axial length adjustment techniques to improve refractive predictability of eyes with extreme axial myopia. With this case report, we would like to demonstrate that even in rare cases of extreme, high myopia and eyeball length &amp;gt; 35 mm, good results can be achieved with correct IOL power implantation if certain considerations are made prior and during the procedure. Special considerations should be taken into account to maximize patient satisfaction.<\/jats:p>","DOI":"10.3389\/fmed.2025.1450922","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T14:44:17Z","timestamp":1751640257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraocular lens calculation for cataract surgery in high myopia: a case report of an extreme axial eyeball length of 35.7 mm"],"prefix":"10.3389","volume":"12","author":[{"given":"Andreas F.","family":"Borkenstein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva-Maria","family":"Borkenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"979","DOI":"10.3760\/cma.j.cn112142-20220309-00101","article-title":"[Impact of capsular tension ring implantation in cataract patients with high myopia].","volume":"58","author":"Lin","year":"2022","journal-title":"Zhonghua Yan Ke Za Zhi."},{"key":"B2","doi-asserted-by":"publisher","first-page":"805706","DOI":"10.1155\/2015\/805706","article-title":"Epidemiology, etiology, and prevention of late IOL-capsular bag complex dislocation: Review of the literature.","volume":"2015","author":"Ascaso","year":"2015","journal-title":"J Ophthalmol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12886-022-02300-6","article-title":"Associations between anterior segment biometry and high axial myopia in 3438 cataractous eyes in the Chinese population.","volume":"22","author":"Miao","year":"2022","journal-title":"BMC Ophthalmol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1167\/iovs.62.5.5","article-title":"IMI pathologic myopia.","volume":"62","author":"Ohno-Matsui","year":"2021","journal-title":"Invest Ophthalmol Vis Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1279718","DOI":"10.3389\/fpubh.2023.1279718","article-title":"The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: A systematic review and network meta-analysis.","volume":"11","author":"Zhou","year":"2023","journal-title":"Front Public Health."},{"key":"B6","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/ICU.0000000000000914","article-title":"Cataract surgery in myopic eyes.","volume":"34","author":"Elhusseiny","year":"2023","journal-title":"Curr Opin Ophthalmol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/ICU.0b013e32834cd653","article-title":"Risk factors for retinal detachment following cataract surgery.","volume":"23","author":"Haug","year":"2012","journal-title":"Curr Opin Ophthalmol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"100314","DOI":"10.1016\/j.xops.2023.100314","article-title":"Incidence and risk factors for retinal detachment and retinal tear after cataract surgery: IRIS(R) registry (Intelligent Research in Sight) analysis.","volume":"3","author":"Morano","year":"2023","journal-title":"Ophthalmol Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/s0896-1549(05)70268-6","article-title":"Retinal detachment.","volume":"14","author":"Banker","year":"2001","journal-title":"Ophthalmol Clin North Am."},{"key":"B10","doi-asserted-by":"publisher","first-page":"876","DOI":"10.18240\/ijo.2016.06.15","article-title":"Comparison axial length measurements from three biometric instruments in high myopia.","volume":"9","author":"Wang","year":"2016","journal-title":"Int J Ophthalmol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"844","DOI":"10.18240\/ijo.2019.05.23","article-title":"Comparison of OA-2000 and IOL Master 500 using in cataract patients with high myopia.","volume":"12","author":"Du","year":"2019","journal-title":"Int J Ophthalmol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.3760\/cma.j.issn.0412-4081.2017.04.007","article-title":"[Intraocular lens power calculation for high myopic eyes with cataract: Comparison of three formulas].","volume":"53","author":"Zhu","year":"2017","journal-title":"Zhonghua Yan Ke Za Zhi."},{"key":"B13","doi-asserted-by":"publisher","first-page":"126","DOI":"10.4103\/0974-620X.71888","article-title":"Accuracy of intraocular lens power calculation in high myopia.","volume":"3","author":"Ghanem","year":"2010","journal-title":"Oman J Ophthalmol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1016\/s0886-3350(02)01976-4","article-title":"Intraocular lens power calculation formulas in Chinese eyes with high axial myopia.","volume":"29","author":"Tsang","year":"2003","journal-title":"J Cataract Refract Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.ajo.2019.04.019","article-title":"Accuracy and precision of intraocular lens calculations using the new hill-RBF version 2.0 in eyes with high axial myopia.","volume":"205","author":"Wan","year":"2019","journal-title":"Am J Ophthalmol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.jcrs.2009.02.026","article-title":"Accuracy of modern intraocular lens power calculation formulas in refractive lens exchange for high myopia and high hyperopia.","volume":"35","author":"Terzi","year":"2009","journal-title":"J Cataract Refract Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"538","DOI":"10.3928\/1081597X-20210506-01","article-title":"Comparison of IOL power calculation formulas for a trifocal IOL in eyes with high myopia.","volume":"37","author":"Tan","year":"2021","journal-title":"J Refract Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1016\/j.jcrs.2009.04.028","article-title":"Intraocular lens power calculation and optimized constants for highly myopic eyes.","volume":"35","author":"Petermeier","year":"2009","journal-title":"J Cataract Refract Surg."},{"key":"B19","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.jcrs.2014.06.033","article-title":"Intraocular lens power calculation for eyes with an axial length greater than 26.0 mm: Comparison of formulas and methods.","volume":"41","author":"Abulafia","year":"2015","journal-title":"J Cataract Refract Surg."},{"key":"B20","doi-asserted-by":"publisher","first-page":"762761","DOI":"10.3389\/fmed.2022.762761","article-title":"Predictability of 6 intraocular lens power calculation formulas in people with very high myopia.","volume":"9","author":"Chu","year":"2022","journal-title":"Front Med (Lausanne)."},{"key":"B21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.4103\/2277-9175.210657","article-title":"The Comparative study of refractive index variations between haigis, Srk\/T and Hoffer-Q formulas used for preoperative biometry calculation in patients with the axial length >25 mm.","volume":"6","author":"Razmjoo","year":"2017","journal-title":"Adv Biomed Res."},{"key":"B22","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.sjopt.2010.03.006","article-title":"Intra-ocular lens power calculation in patients with high axial myopia before cataract surgery.","volume":"24","author":"El-Nafees","year":"2010","journal-title":"Saudi J Ophthalmol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"207","DOI":"10.3928\/1081597X-20201123-01","article-title":"A comparison of intraocular lens power calculation formulas in high myopia.","volume":"37","author":"Bernardes","year":"2021","journal-title":"J Refract Surg."},{"key":"B24","doi-asserted-by":"publisher","first-page":"484","DOI":"10.4103\/ijo.IJO_937_18","article-title":"Accuracy of the refractive prediction determined by intraocular lens power calculation formulas in high myopia.","volume":"67","author":"Zhou","year":"2019","journal-title":"Indian J Ophthalmol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"305","DOI":"10.4103\/tjo.tjo_7_21","article-title":"Clinical outcomes and comparison of intraocular lens calculation formulas in eyes with long axial myopia.","volume":"12","author":"Ang","year":"2022","journal-title":"Taiwan J Ophthalmol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s40001-024-01726-6","article-title":"Effect of capsular tension ring on the refractive outcomes of patients with extreme high axial myopia after phacoemulsification.","volume":"29","author":"Zhao","year":"2024","journal-title":"Eur J Med Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"943","DOI":"10.18240\/ijo.2019.06.10","article-title":"Effect of lens constants optimization on the accuracy of intraocular lens power calculation formulas for highly myopic eyes.","volume":"12","author":"Zhang","year":"2019","journal-title":"Int J Ophthalmol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"754","DOI":"10.3928\/1081597X-20210712-08","article-title":"Accuracy of newer generation IOL power calculation formulas in eyes with high axial myopia.","volume":"37","author":"Lin","year":"2021","journal-title":"J Refract Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s40662-023-00342-5","article-title":"The Zhu-Lu formula: A machine learning-based intraocular lens power calculation formula for highly myopic eyes.","volume":"10","author":"Guo","year":"2023","journal-title":"Eye Vis (Lond)."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1007\/s10792-020-01684-y","article-title":"Intraocular lens power calculation for plus and minus lenses in high myopia using partial coherence interferometry.","volume":"41","author":"Fuest","year":"2021","journal-title":"Int Ophthalmol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1016\/j.jcrs.2011.05.042","article-title":"Optimizing intraocular lens power calculations in eyes with axial lengths above 25.0 mm.","volume":"37","author":"Wang","year":"2011","journal-title":"J Cataract Refract Surg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1016\/j.jcrs.2018.07.049","article-title":"Modified axial length adjustment formulas in long eyes.","volume":"44","author":"Wang","year":"2018","journal-title":"J Cataract Refract Surg."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1007\/s40123-023-00711-2","article-title":"Long-term outcomes of posterior capsular opacification in highly myopic eyes and its influencing factors.","volume":"12","author":"He","year":"2023","journal-title":"Ophthalmol Therapy."},{"key":"B34","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1136\/bjo.85.5.543","article-title":"Silicone oil-intraocular lens interaction: Which lens to use?","volume":"85","author":"McLoone","year":"2001","journal-title":"Br J Ophthalmol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1159\/000068561","article-title":"Interaction of intraocular lenses with various concentrations of silicone oil: An experimental study.","volume":"217","author":"Oner","year":"2003","journal-title":"Ophthalmologica."},{"key":"B36","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4103\/2277-9175.102971","article-title":"A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length.","volume":"1","author":"Fesharaki","year":"2012","journal-title":"Adv Biomed Res."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1097\/j.jcrs.0000000000000664","article-title":"Efficacy and complications of cataract surgery in high myopia.","volume":"47","author":"Yao","year":"2021","journal-title":"J Cataract Refract Surg."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1450922\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T14:44:18Z","timestamp":1751640258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1450922\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":37,"alternative-id":["10.3389\/fmed.2025.1450922"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1450922","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,4]]}}}