Abstract
INTRODUCTION AND IMPORTANCE: Albinism-associated ocular conditions, such as nystagmus and macular hypoplasia, present significant challenges in surgical interventions. The use of femtosecond laser-assisted lens exchange with trifocal intraocular lens (IOL) implantation in such cases is not well-documented. This case highlights the feasibility and effectiveness of this approach, demonstrating its potential in addressing complex visual impairments while achieving spectacle independence. CASE PRESENTATION: A 56-year-old male with albinism and congenital nystagmus presented with progressive myopia and presbyopia, seeking spectacle independence. Preoperative evaluation revealed elongated axial lengths (OD: 27.21 mm, OS: 27.83 mm), significant lens dysfunction (DLI OD: 8.47, OS: 7.03), and nystagmus-related fixation instability. Bilateral femtosecond laser-assisted lens exchange with AcrySof IQ PanOptix trifocal IOL implantation was performed successfully. Postoperatively, the patient achieved significant improvements in visual acuity at all distances, complete spectacle independence, and high satisfaction without complications. CLINICAL DISCUSSION: This case demonstrates that despite the challenges posed by nystagmus and macular hypoplasia, femtosecond laser technology can enable precise surgical execution and optimal IOL positioning. The trifocal IOL provided functional vision restoration across near, intermediate, and far distances. While concerns regarding multifocal IOLs in patients with retinal dysfunction persist, this case supports their potential applicability in select cases. Additionally, the procedure was well-tolerated despite the inherent photophobia of albinism, and postoperative nystagmus remained stable without worsening visual function. CONCLUSION: Femtosecond laser-assisted lens exchange with trifocal IOL implantation can be a viable surgical option for patients with albinism and nystagmus, addressing refractive challenges while achieving spectacle independence. This case underscores the importance of individualized surgical planning and advanced technology in overcoming complex ocular conditions. Further studies are needed to validate long-term outcomes in similar patient populations.