title: Consistent pattern in positional instability of polyfocal full-optics accommodative IOL.
abstract: OBJECTIVE
  We describe cases of dislocation or subluxation of the WIOL-CF®polyfocal full-optics intraocular lens (IOL) and suggest a consistent pattern and possible mechanism for the IOL instability.
  
  
  METHODS
  This is a retrospective case series of five consecutive eyes in three patients with WIOL-CF®IOL instability at Keimyung University Dongsan Medical Center and Kimkisan Eye Center from 2012 to 2014. The medical records and ocular exam data for these patients were analyzed.
  
  
  RESULTS
  A 50-year-old male had uneventful phacoemulsification in both eyes with WIOL-CF®IOL implantation. At 27 months after surgery, the patient was referred to our clinic with a dislocated IOL in the left eye. The IOL in the right eye was dislocated in the same pattern 38 months after cataract surgery. Another 50-year-old male, who had phacoemulsification and WIOL-CF®IOL implantation in both eyes, was referred to our clinic following diagnosis of a subluxated IOL. Both IOLs were well centered; however, the infranasal aspect of the IOLs tilted posteriorly, and the supratemporal portion the IOLs tilted anteriorly, with overlying iris atrophy in a symmetric pattern. The inferonasal continuous curvilinear capsulorrhexis (CCC) edge was dragged superotemporally, and the supratemporal CCC edge was identified on the posterior surface of the IOL. A 16-year-old female had uneventful phacoemulsification and WIOL-CF®IOL implantation to treat a cataract in the right eye, and 3 years later, the IOL tilted with the same pattern as the previous case.
  
  
  CONCLUSIONS
  Years after uncomplicated phacoemulsification, an implanted WIOL-CF®IOL may tilt and dislocate in the absence of trauma, in a consistent and characteristic pattern.
authors.affiliation: Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea. eyedr@dsmc.or.kr.
authors.forename: Yu Cheol
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea.
authors.forename: Kyung Tae
authors.initials: KT
authors.lastname: Kang
authors.affiliation: Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea.
authors.forename: Youngdo
authors.initials: Y
authors.lastname: Yeo
authors.affiliation: Kimkisan Eye Center, Daegu, Korea.
authors.forename: Ki-San
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Frank S
authors.initials: FS
authors.lastname: Siringo
mesh_terms: D000065:Accommodation, Ocular; D000293:Adolescent; D060437:Artificial Lens Implant Migration / Q000473:pathology*; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000473:pathology*; D012189:Retrospective Studies
keywords: Dislocation; Instability; Intraocular lens; Subluxation