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Unusual sequel to a known complication
  1. K Merchant,
  2. R Stirling
  1. Department of Ophthalmology, Darlington Memorial Hospital, Darlington, County Durham, UK
  1. Mr K Merchant, Department of Ophthalmology, Darlington Memorial Hospital, Hollyhurst Road, Darlington, County Durham DL3 6HX, UK; kinnar{at}doctors.org.uk

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A 76-year-old man underwent cataract surgery with implantation of an acrylic foldable intraocular lens by standard phacoemulsification technique. The preoperative and immediate postoperative period was uneventful. His postoperative visual acuity was 6/6.

However, 3 months later he gradually developed visual problems while doing close work or reading, although his distant visual acuity still remained 6/6.

He visited the eye casualty with the above complaints and the following slit-lamp picture was noted.

What condition is seen in the picture (fig 1) and what may have caused it?

Figure 1 Folded lower haptic of intraocular lens implant (IOL) in the contracted capsule. Photograph taken with direct focal illumination of slit-lamp.

BRIEF ANSWER

Modern phacoemulsification cataract surgery involves injecting a pliable intraocular lens implant (IOL) with a total diameter 12.5 mm through a sub 3 mm incision. The IOL unfolds into the original lens capsule.

Although initially delighted with the result of his surgery, this patient noticed a progressive disturbance of his vision 3 months after surgery.

The supporting leg or haptic …

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