Strabismus following implantable anterior intraocular lens surgery

Strabismus in adults is increasing and has recently become an important focus of attention due to the development of refractive surgery techniques. In this case, permanent strabismus developed in a woman with previous high myopia after implantable anterior intraocular lens surgery. An ophthalmologic examination revealed the presence of a lens which was placed slightly downward in relation to the center of visual axis in the anterior chambers and up-drawn pupils in both eyes. The prismatic effect due to lens decentration may be the main cause of strabismus. Therefore, we suggest precise intraocular lens insertion and placement technique during surgery as well as careful ophthalmologic assessment including cover/uncover tests in all candidates for refractive surgery and full ocular motility evaluation if there is any doubt about binocular issues.