Reposition of a Misaligned Zeiss AT TORBI 709M® Intraocular Lens 15 Months after Implantation

Abstract

Purpose To report the treatment of a patient with a misaligned intraocular lens (IOL). Methods We describe a case of a misaligned bitoric single-piece, plate haptic IOL (AT TORBI 709M®, Carl Zeiss Meditec AG, Jena, Germany) 15 months after uneventful phacoemulsification and IOL implantation in the capsular bag. Keratoconus with partly regular astigmatism was preexisting. Results Thorough examination showed a misalignment of the bitoric IOL of 25 degrees, explaining the patient's symptoms (monocular diplopia). Despite capsular fibrosis, surgical revision with IOL rotation was advised and could be performed without major difficulty. A follow-up visit showed a corrected distance visual acuity of 16/20 and a correctly aligned toric IOL. Conclusions A long preceding operation should not detain the surgical revision of a misaligned toric IOL in the capsular bag.