Look carefully at the picture and see if you can determine why the IOL is decentered? The capsulorhexis looks good and it is nicely centered, so that means that zonular support should be reasonable, right? Perhaps the posterior capsule is damaged? Or maybe there is another reason. This patient was sent to our guest surgeon about a week or two after the original cataract surgery was performed elsewhere. What do you think is going on and how would you fix it?