This patient had cataract surgery about a year ago and now presents to you with an IOL that is very decentered. The patient’s vision is now compromised and surgery is planned to address the issues. Look at the photo and think about the whitish haze that you see above the optic edge close to the incision. Would you do an IOL exchange? Just a reposition? Maybe something more involved. Leave a comment before watching the video.
It seems like there was a running of the capsulorhexis at the time of the initial operation
The ccc is asimetrical subincisionaly, and maybe the posterior capsule is ruptured with vitreous prolapse
If vitreous presence is confirmed with triamcinolone, a anterior vitrectomy and IOL reposition is a must. If the IOL can not be properly repositioned and centered in the sulcus, an IOL exchange with/without scleral fixation is indicated