title: Identification of the source of permanent glare from a three-piece IOL.
abstract: OBJECTIVE
  To identify the source of unwanted glare images from a three-piece intraocular lens (IOL) implant following cataract surgery.
  
  
  METHODS
  The IOL and posterior capsule were examined under mydriatic and nonmydriatic conditions using direct focal illumination from a slit lamp biomicroscope. Direct focal illumination was undertaken with both a narrow beam (0.1 mm in width) and small spot (0.1 mm in diameter) to identify the points at which the glare images were stimulated. While observing the location of the beam with the slit lamp biomicroscope, the patient indicated when the glare images were stimulated.
  
  
  RESULTS
  The nasal haptic insertion into the optic was identified as the source of temporal line images arising from lights such as headlamps from oncoming cars and street lamps. The adjacent edge of the IOL was also identified as the likely source of additional cob web-like light rays.
  
  
  CONCLUSIONS
  The haptic insertions in three-piece IOLs may, under certain conditions, interfere with light entering the pupil and produce extraneous images. Large mesopic pupils and decentred IOLs are conditions that increase the likelihood of unwanted glare images.
authors.affiliation: Moseley, Birmingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Wolffe
authors.forename: R J
authors.initials: RJ
authors.lastname: Landry
authors.forename: J J
authors.initials: JJ
authors.lastname: Alpar
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D019466:Glare; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D011474:Prosthesis Design; D016896:Treatment Outcome; D014792:Visual Acuity