Polypseudophakia with the J&J synergy lens in high myopia: case report
- 1Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USA
- 2Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
- 3Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, CA, USA
Abstract
Introduction and importance:: As clinicians strive to provide personalized recommendations for patients, polypseudophakia may be an option for those outside the range of traditional extended depth-of-focus lenses. We describe a case with initial refractive success but the development of a potentially vision-threatening complication.
Presentation of case:: A 40-year-old Asian man with high myopia presented for a refractive surgery consultation with a goal of total spectacle independence and underwent bilateral refractive lens exchange with the J&J Synergy lens in the capsular bag, and a minus-power Alcon MA60MA lens in the sulcus. Initially, there was refractive success with post-operative uncorrected distance vision of 20/20 in the right eye and 20/25 in the left eye at 6 months. However, both eyes developed transillumination defects with pigment in the anterior chamber, consistent with Uveitis-Glaucoma-Hyphema (UGH) syndrome. The patient ultimately elected bilateral explantation of the sulcus intraocular lenses (IOLs) due to this complication.
Clinical discussion:: To our knowledge, this is the first case using the J&J Synergy lens in polypseudophakia and the second to correct for high myopia. Surgical techniques for those with high myopia and thin corneas are rare, and this technique initially provided a hopeful refractive outlook. However, loss of the refractive target and the development of UGH syndrome challenged the safety of this technique.
Conclusion:: Further studies are needed to determine which patients can tolerate this procedure. Providers should proceed cautiously and anticipate complications such as UGH syndrome following secondary sulcus IOL placement.
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BibTeX
@article{durgan2026polypseudophakia,
title = {{Polypseudophakia with the J&J synergy lens in high myopia: case report}},
author = {David Durgan and Noah Collins and Jessica Kim and Frank Hwang},
journal = {International Journal of Surgery Case Reports},
year = {2026},
month = oct,
doi = {10.1097/rc9.0000000000001076},
url = {https://doi.org/10.1097/rc9.0000000000001076},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Polypseudophakia with the J&J synergy lens in high myopia: case report
AU - David Durgan
AU - Noah Collins
AU - Jessica Kim
AU - Frank Hwang
PY - 2026
DA - 2026/10/14
JO - International Journal of Surgery Case Reports
DO - 10.1097/rc9.0000000000001076
UR - https://doi.org/10.1097/rc9.0000000000001076
AB - Introduction and importance:: As clinicians strive to provide personalized recommendations for patients, polypseudophakia may be an option for those outside the range of traditional extended depth-of-focus lenses. We describe a case with initial refractive success but the development of a potentially vision-threatening complication. Presentation of case:: A 40-year-old Asian man with high myopia presented for a refractive surgery consultation with a goal of total spectacle independence and underwent bilateral refractive lens exchange with the J&J Synergy lens in the capsular bag, and a minus-power Alcon MA60MA lens in the sulcus. Initially, there was refractive success with post-operative uncorrected distance vision of 20/20 in the right eye and 20/25 in the left eye at 6 months. However, both eyes developed transillumination defects with pigment in the anterior chamber, consistent with Uveitis-Glaucoma-Hyphema (UGH) syndrome. The patient ultimately elected bilateral explantation of the sulcus intraocular lenses (IOLs) due to this complication. Clinical discussion:: To our knowledge, this is the first case using the J&J Synergy lens in polypseudophakia and the second to correct for high myopia. Surgical techniques for those with high myopia and thin corneas are rare, and this technique initially provided a hopeful refractive outlook. However, loss of the refractive target and the development of UGH syndrome challenged the safety of this technique. Conclusion:: Further studies are needed to determine which patients can tolerate this procedure. Providers should proceed cautiously and anticipate complications such as UGH syndrome following secondary sulcus IOL placement.
SN - 2210-2612
ER -