Malpositioned Phakic IOL: When You Cannot Turn It Loose

Phakic intraocular lenses are a great alternative to laser vision correction in people with higher refractive errors and thinner corneal pachymetry. However, the success of refractive surgery depends largely on meticulous technique and proper counseling. Not only does intraoperative surgical technique matter, but also a high index of suspicion should be maintained when postoperative outcomes are not as planned. This chapter provides insight into one such case where suboptimal vision gain after implantation of an indigenous phakic intraocular lens prompted a search into the cause. The tips to identify an incorrect orientation of the phakic intraocular lens and the proper technique of loading and implantation are described in detail in this chapter.