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2018•Taiwan Journal of OphthalmologyOpen access

Lens exchange for management of accommodative intraocular lens tilting

Amin Nabavi, Masoumeh Mohebbi, AliBanafsheh Afshan, Bahman Inanloo

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Abstract

Accommodative intraocular lens (IOL) tilting, the so-called Z syndrome, is a rare complication of Crystalens (Bausch and Lomb) implantation. We report a significant IOL tilting and subsequent high lenticular astigmatism due to posterior capsular fibrosis 2 months after uncomplicated cataract surgery and Crystalens (AT50AO) implantation. The attempt to correct IOL position with neodymium-yttrium-aluminum garnet laser was unsuccessful, and Crystalens exchange with in-the-sulcus, three-piece monofocal IOL was performed. Accommodative IOL tilting could occur early after the surgery. Laser capsulotomy may be the first intervention to restore IOL position, but patients with a higher amount of lenticular astigmatism may require surgical intervention and IOL exchange.

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What this paper is about

Accommodative intraocular lens (IOL) tilting, the so-called Z syndrome, is a rare complication of Crystalens (Bausch and Lomb) implantation. We report a significant IOL tilting and subsequent high lenticular astigmatism due to posterior capsular fibrosis 2 months after uncomplicated cataract surgery and Crystalens (AT50AO) implantation. The attempt to correct IOL position with neodymium-yttrium-aluminum garnet laser was unsuccessful, and Crystalens exchange with in-the-sulcus, three-piece monofocal IOL was performed. Accommodative IOL tilting could occur early after the surgery. Laser capsulotomy may be the first intervention to restore IOL position, but patients with a higher amount of lenticular astigmatism may require surgical intervention and IOL exchange.

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Available abstract

Accommodative intraocular lens (IOL) tilting, the so-called Z syndrome, is a rare complication of Crystalens (Bausch and Lomb) implantation. We report a significant IOL tilting and subsequent high lenticular astigmatism due to posterior capsular fibrosis 2 months after uncomplicated cataract surgery and Crystalens (AT50AO) implantation. The attempt to correct IOL position with neodymium-yttrium-aluminum garnet laser was unsuccessful, and Crystalens exchange with in-the-sulcus, three-piece monofocal IOL was performed. Accommodative IOL tilting could occur early after the surgery. Laser capsulotomy may be the first intervention to restore IOL position, but patients with a higher amount of lenticular astigmatism may require surgical intervention and IOL exchange.

Key concepts: Medicine, Intraocular lens, Astigmatism, Ophthalmology, Capsulotomy, Phacoemulsification, Cataract surgery, Optometry

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