Reversed vaulted AcrySof intraocular lens presenting as pupillary block

We report a case of a patient who 4 weeks after uneventful phacoemulsification, underwent a dilated fundal examination, and subsequently developed pupil block. The intraocular lens was noted to be reversed, and thereby vaulted anteriorly. Repositioning of the lens into the bag at the slit lamp lead to resolution of the pupillary block with no further recurrence.

A 68-year-old man with diabetes and end-stage renal failure underwent routine left phacoemulsification in March 2007 with +22.0 dioptre AcrySof MA60AC lens implantation in the capsular bag (three-piece, 6 mm biconvex optic, 13 mm length, polypropylene haptics posteriorly vaulted 10°). Four weeks postoperatively he could see 6/9 unaided and underwent dilated fundal examination. At 0500 hours the following morning he woke with a severe pain in his left eye but did not present to the eye unit until 2000 hours.

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