Eccentric capsulorhexis and postoperative dysphotopsia following phacoemulsification.

We report a case of troublesome visual symptoms or dysphotopsia in a 68-year-old patient after right phacoemulsification and implantation of a 3-piece AcrySof(R) MA60BM acrylic intraocular lens (IOL) (Alcon) in the capsular bag. The patient described multiple horizontal streaks in dim lighting conditions with light sources in the right temporal visual field. The anterior capsulorhexis was eccentric, leaving the nasal optic edge and site of polypropylene haptic insertion uncovered by the semi-opaque anterior capsule and the probable source of the flare images. Miotic therapy was poorly tolerated and IOL exchange declined. The case illustrates the importance of creating a central capsulorhexis smaller than the IOL optic to reduce the risk photic phenomena and edge effect with square-edged IOLs.