Accommodative intraocular lens tilting
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Updated: Aug 16, 2026

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Jorge Cazal1, Cosme Lavin-Dapena, Jesus Marín
1Department of Ophthalmology, Institut Universitari Dexeus, Barcelona, Universidad Autónoma de Barcelona, Barcelona, Spain. jcazal@cverges.com
Purpose:
To report an unusual complication of accommodative intraocular lens (IOL) implantation after clear lens extraction for hyperopia correction.
Design:
Observational case report.
Method:
A 48-year-old woman underwent clear lens exchange for the correction of moderate hyperopia. A Crystalens Model AT-45 Accommodating Posterior Chamber IOL (AT-45 IOL) was implanted to allow optimal distance and near vision. At the 3-week follow-up appointment, she complained of monocular diplopia. Ocular examination showed an increased astigmatism, causing decreased visual acuity. Scheimpflug Pentacam Image and Wave Front Analysis supported the diagnosis of IOL tilting.
Results:
IOL repositioning was unsuccessful because of fibrosis of the haptics. It was necessary to replace AT 45 IOL with a monofocal acrylic sulcus-fixated IOL.
Conclusion:
Control of capsular fibrosis should be a major concern, especially in this type of IOL. Accommodating IOL exchange appears to be a safe alternative to manage this complication.
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