Choosing an intraocular lens for patients with large pupils

Optical aberration from the positioning holes of a posterior chamber intraocular lens was encountered in three patients with wide spontaneous dilation of the pupil in scotopic conditions. One patient had a cataract extraction in his fellow eye with implantation of a posterior chamber lens without positioning holes in its optical portion and has not encountered any aberrations in that eye. We suggest that in such patients, careful preoperative measurement of the pupillary size in a dark room should be done and lenses without positioning holes on the optic should be used to prevent optical aberrations.