Improvement in vision with inverted placement of an asymmetric refractive multifocal intraocular lens

We report the case of a 73-year-old man who presented for bilateral cataract surgery. He was noted to have a 0.5 mm corneal scar inferonasally at the pupil margin in his right eye. Uneventful bilateral cataract surgery was performed. An asymmetric toric refractive multifocal intraocular lens (IOL) (LU-313MF30T, Lentis MPlus toric) was implanted in the right eye. Postoperatively, the uncorrected distance visual acuity (UDVA) in that eye was 6/6^-3, the uncorrected intermediate visual acuity at 60 cm was J4, and the uncorrected near visual acuity (UNVA) at 40 cm was J8. The patient was not satisfied with the UNVA. Corneal topography showed 3.0 diopters (D) of corneal flattening over the +3.00 D near segment. The IOL was rotated 180 degrees, which improved the UNVA to J1 while maintaining the UDVA. This study demonstrates that the Lentis Mplus can function even when the near segment is not positioned inferiorly. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.