High-Speed Photographic Evaluation of Intraocular Lens Movements

Iridodonesis and pseudophakodonesis were examined in detail with a high-speed camera capable of picture rates up to 500/sec. Tilting, or “wobble,” of iris-supported intraocular lenses was extreme, with a tilt of nearly 24 degrees with respect to the visual axis of the globe being documented, even with a moderate speed of globe rotation. Oscillations of the lens continued for several cycles after the globe stopped its rotation. Such lenses can, in some instances, tilt sufficiently to contact the endothelial surface of the cornea. In the case of some anterior chamber intraocular lenses, the iridodonesis is sufficient to cause constant rubbing of the iris on the posterior surface of the lens and its haptics, suggesting that vault, finish, haptic configuration, and placement of the lens may be critical factors in anterior chamber intraocular lens design.