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Discordant Visual Outcome after Premium IOL Implantation: Unveiling Paracentral Acute Middle Maculopathy on OCT

Author

Listed:
  • Loubna Mouhib

    (Mohammed VI International University Hospital (UM6SS), Morocco)

  • Hala Ait Amar

    (Mohammed VI International University Hospital (UM6SS), Morocco)

  • Mehdi Khamaily

    (Mohammed VI International University Hospital (UM6SS), Morocco)

  • Latifa Mernissi

    (Mohammed VI International University Hospital (UM6SS), Morocco)

  • Mohamed Elbelhadji

    (Mohammed VI International University Hospital (UM6SS), Morocco)

Abstract

Background: Premium intraocular lenses (IOLs), including extended depth of focus (EDOF) designs, provide excellent functional outcomes. However, unexplained postoperative visual dissatisfaction requires thorough evaluation, particularly of the macula. Case presentation: We report a 60-year-old patient who underwent sequential cataract surgery with implantation of an EDOF IOL (Vivity). The first eye achieved 10/10 postoperatively. The second eye had a preoperative acuity of 9/10 but remained limited to 4/10 postoperatively despite proper IOL positioning and clear media. Fundus examination was unremarkable. Macular OCT revealed hyper reflectivity of the inner nuclear layer, consistent with paracentral acute middle maculopathy (PAMM). Conclusion: PAMM is a rare but relevant cause of unexplained visual loss after cataract surgery. OCT is essential in such cases to avoid misattributing poor outcomes to IOL performance.

Suggested Citation

  • Loubna Mouhib & Hala Ait Amar & Mehdi Khamaily & Latifa Mernissi & Mohamed Elbelhadji, 2026. "Discordant Visual Outcome after Premium IOL Implantation: Unveiling Paracentral Acute Middle Maculopathy on OCT," European Journal of Medical and Health Sciences, European Open Science, vol. 8(3), pages 29-31, May.
    • Handle: RePEc:epw:ejmed0:v:8:y:2026:i:3:id:70356
    DOI: 10.24018/ejmed.2026.8.3.70356
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