Acute clouding of a trifocal intraocular lens during implantation: A case report

PURPOSE: In this paper, we present a case of acute clouding of a trifocal intraocular lens (IOL) that resolved spontaneously by the day after surgery. OBSERVATIONS: A 68-year-old woman with a nuclear cataract in the right eye was scheduled for cataract surgery with +21.00 diopter trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec AG, Germany) implantation. Phacoemulsification was uneventful until the implantation of the IOL. Although the IOL was initially transparent, we observed acute clouding of the IOL optic immediately upon implantation into the eye, and the IOL remained cloudy at the end of the surgery. On the day after surgery, we observed that the clouding was completely resolved. CONCLUSIONS AND IMPORTANCE: We think that the sudden temperature change of the IOL upon implantation into the anterior chamber may have caused acute clouding. If a similar situation is encountered, clinicians should avoid explantation or replacement of the Zeiss AT LISA trifocal IOL, as the clouding resolves spontaneously.