Objective Assessment of the Quality of Vision Before and After Repositioning of a Dislocated Iris-fixated Aphakic Anterior Chamber Lens

PURPOSE: To document severe visual symptoms due to the dislocation of an iris-fixated aphakic anterior chamber lens using wavefront aberrometry. METHODS: A patient complaining of severe visual blur and distortion due to a decentered Artisan iris-fixated anterior chamber lens was evaluated pre- and postoperatively after recentration. The patient underwent complete ophthalmic evaluation including the measurement of corneal topography and wavefront aberrations using the NIDEK OPD-Scan. OPD Station software was used to correlate and simulate the patient's symptoms. RESULTS: After the repositioning procedure, the visual symptoms resolved, and high magnitudes of tilt (7.536 microm) and high order aberrations (5.129 microm) were dramatically reduced by simple lens repositioning (4.40-mm pupil). The cylinder magnitude was reduced from 6.25 to 0.75 diopters. CONCLUSIONS: These are the first diagnostic images of this kind in a highly aberrated eye with iris-fixated anterior chamber lens dislocation. The images documented the optical effect and visual consequences of IOL decentration and subsequent recentration.