Abstract
Posterior chamber intraocular lens (PC-IOL) dislocation occurs due to suboptimal posterior capsule support. Subluxated PC-IOLs involve more extensive dislocation, generally with an open pupillary space, but with the IOL lodged in the anterior vitreous, behind the iris, commonly with one haptic binding to capsular remnants or the vitreous base. IOLs with simple decentration are usually managed satisfactorily by observation or topical miotics. Patients with multifocal IOLs are particularly vulnerable to symptoms from otherwise minor decentration, and may require surgical management. Recognizing and utilizing adequate capsular support is as important for successful IOL repositioning as it is for primary placement. IOL torsion and decentration can be minimized by accurate ciliary sulcus placement and by adequate excision of bulky capsular and cortical remnants. Recommendations to the anterior segment surgeon encountering PC-IOL dislocation intraoperatively include performing an anterior vitrectomy to avoid vitreous incarceration in the wound.