In-the-bag decentration of a hydrophilic radially asymmetric multifocal intraocular lens secondary to capsule contraction.

We report a case of in-the-bag decentration and tilt of a hydrophilic rotationally asymmetric multifocal intraocular lens (IOL) of the M Plus type secondary to capsule contraction. After uneventful surgery and follow-up for 3 months, progressive decentering and tilting of the IOL secondary to capsule contraction and capsulorhexis phimosis was noticed. A surgical procedure was necessary to restore correct centration of the IOL. The uncorrected distance and near visual acuities were restored to logMAR 0. Hydrophilic multifocal IOLs of this specific design may be sensitive to postoperative decentration. Capsular tension rings may alleviate the problem in a secondary repair procedure. The softness of the C-loop haptics of this IOL type may also play a role in the decentration.