Hyperopic shift from posterior migration of hydrophilic acrylic intraocular lens optic

Two cases that developed a delayed hyperopic shift in refraction following implantation of a single-piece hydrophilic intraocular lens (IOL) are described. The haptics of the Akreos Adapt IOL were flexed anteriorly by capsular contraction, leaving a marked gap between the optic and the anterior capsule. A third case that had marked capsule phimosis and similar anterior flexion of the haptics but with a stable refraction is also described. In this case, the anterior and posterior leaves of the capsule fused peripherally and the IOL optic position was normal. The effective power of an IOL depends on the distance between the apex of the cornea and the center of the optic. Capsule contraction without fusion of the peripheral capsule can make the haptics of this IOL design flex anteriorly with posterior movement of the optic and a hyperopic shift in refraction.

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