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Dysphotopsia following a plano sulcus intraocular lens in an amblyopic myopic eye

Poster Details

First Author: J.Panthagani UK

Co Author(s):    W. Fusi-Rubiano   T. Gillow                 

Abstract Details


To describe the unusual case of dysphotopsia from a tilted and decentred plano sulcus intraocular lens in an amblyopic myopic eye.


Royal Stoke University Hospital NHS Trust


A 79-year-old myopic patient (-12D spherical equivalent) underwent an eventful right eye (RE) cataract operation with posterior capsular bag compromise. A plano sulcus lens (Alcon Acrysoft MA60MA lens) was placed at the time of the operation; however, the leading haptic of the lens was distorted as it was passed through the main section but gradually unfolded in the eye. Post op evaluation on day 1 revealed a decentred and tilted lens.


The pre op visual acutity (VA) of the RE was hand movements (HM) and the axial length 30.97mm. The predicted post op refraction was -0.15D. 8/52 post op refraction of the RE was �.00/-2.25x90. The patient was monitored in several outpatient clinic appointments after the operation and complained of tilted images overlapping each other with both eyes open that�Â� improved with RE shut. 3 months post op revealed a best corrected VA (BCVA) of 6/18. However, a decision was made for exchange of lens in an attempt to eradicate the patient�â�€�™s symptoms.


Insertion of a plano lens can act as a barrier to vitreous movement and subsequent retinal traction maintaining the ocular anatomy. The correct folding and insertion of sulcus lenses are important techniques to learn by a trainee surgeon. Any damage to the lens at the time of the initial operation may require lens exchange in order to reduce the chances of tilt and decentration. This may subsequently lead to higher order aberrations perceived with reduced image quality for a patient.

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