Optimized Visual Outcome After Asymmetrical Multifocal IOL Rotation

To report improved visual outcome after rotation of an asymmetrical multifocal intraocular lens (IOL).Case report.A 58-year-old patient underwent bilateral phacoemulsification with asymmetrical multifocal IOL implantation. Postoperative uncorrected distance visual acuity (UDVA) was 0.0 logMAR (20/20 Snellen) and uncorrected near visual acuity was 0.0 logMAR (20/20 Snellen) in both eyes. Quality of vision questionnaire scores for day and night were 5 and 7, respectively. The center of the multifocal IOL in the dominant eye was initially found to be 0.2 mm superotemporally displaced, increasing the percentage area of 'near-add' compared to 'distance-add' within the physiological pupil. Rotation of this IOL 120° clockwise greatly improved the IOL centration within the pupil center and resulted in an immediate improvement in UDVA to -0.1 logMAR (20/16 Snellen) and quality of vision questionnaire scores to 8 and 9, respectively.Assessment of the centration of an asymmetrical multifocal IOL is important, particularly if there are dysphotoptic or other visual complaints. [J Refract Surg. 2016;32(7):494-496.].