Inadvertent insertion of an opposite-power intraocular lens

An 82-year-old woman with age-related cataract and high myopia had uneventful phacoemulsification and intraocular lens (IOL) implantation. Preoperative visual acuity was 20/60 with -16.00 -3.00 x 70 and axial length was 29.29 mm. An IOL (MA60MA, Alcon) of +5.0 diopters (D) was selected with target refraction of -1.5 D. The next day, visual acuity was 20/15 with +5.50 -2.00 x 60. It was found that an IOL of -5.0 D was inadvertently inserted instead of +5.0 D because of an identical package appearance of the opposite-diopter IOLs except for a small negative sign before the diopter label. The -5.0 D IOL was surgically replaced with +5.0 D IOL, and visual acuity became 20/15 with -0.50 -2.00 x 70. When selecting an IOL for highly myopic patients, attention should be paid to the extreme resemblance of the package of opposite-diopter IOLs.