Axial displacement of IOL and visual impairment

Background After a cataract surgery procedure with vitreous loss a vitreous strand remained in the wound. An unusual visual impairment was observed. Patient A shift in refraction depending on the pupillary diameter was obser ved. In miosis the refraction was estimated to + 1,0 sph, in mydriasis - 1, 0 sph/ - 0,5 cyl, respectively. Method We presumed that the vitreous strand between the iris and the intrao cular lens caused an axial displacement of the IOL during the change from m iosis to mydriasis and v.v. Therefore the vitreous strand was surgically el iminated. After surgery the refractive changes by pupillary actions were ov ercome. In a computer simulation tray tracing), the amount of axial displac ement of the IOL was estimated to 1,5 mm. Conclusion This paper reminds of considering other reasons for loss of VA t han CME, e.g. axial displacement of IOL. An adequate method of examination is the measurement of refraction in miosis and mydriasis.