Quiz: Why won’t this IOL stay centered?

This case seemed 100% normal. Reasonable dilation, good zonular support, 5-mm round capsulorhexis, phaco chop, and a normal capsular bag. The single-piece acrylic IOL was injected in a controlled manner and it unfolded normally. Then, at the end of the case, when the viscoelastic was being evacuated from the anterior segment, it was noted that the IOL would not stay centered?

This is a quiz — what do you think is happening?

Click below to see the video where the answer is revealed:


  1. Haptic stuck to optic and resulting in a asymmetric and insufficient support…

  2. For beginners I‘d be cautious to just push the haptic in once visco has been removed. Might be wiser to take the extra effort of putting some visco back under the lens and then rotate it in. Otherwise nice video of a not too unvommon problem.

Leave a Reply