Refractive surprise following implantation of correct powered intraocular lens--a real surprise!

We report a case of a 60-year-old male with unsatisfactory visual outcome following an uneventful phacoemulsification surgery for the left eye at our hospital. The evaluation of his anterior segment revealed a clear cornea, a well-positioned in-the-bag intraocular lens (IOL) and normal posterior segment. His vision in the left eye was 20/160 improving to 20/20 with +6.5 D Sphere. Repeat biometry of the left eye revealed IOL power of 22.0 D, which was same as the power of the IOL implanted during the cataract surgery. The patient underwent IOL explantation and implantation of another foldable IOL of 22.0 D. On follow-up he had an uncorrected visual acuity of 20/20. On evaluation with the Scheiner optical system, the explanted lens was found to have power of +13.92 D. This case highlights the rare possibility of postoperative refractory surprise due to incorrect labelling of the IOL by the manufacturer.