Silicone oil induced high astigmatism in a pseudophakic vitrectomized eye

A 66-year-old male lawyer with dropped whole nucleus during phacoemulsification procedure. He was hepatitis C virus positive, international normalized ratio 1.5, prothrombin concentration 60%, and coagulation time 15.5 s. Positive predictive value was done, nucleus was removed with sleeveless phaco needle through pars plana, an AcrySof three piece intraocular lens (IOL) was implanted in the ciliary sulcus. Postoperative sustained vitreous haze required silicone oil injection. One day postoperatively, vision was counting fingers again, opened posterior capsule, clear fundus details. Refraction revealed: −8 × 120 astigmatic error correcting the patient to 0.2 vision (decimal fraction) with uniocular diplopia; as the patient claimed. Corneal topography revealed minimal corneal astigmatic error. By revising patient′s clinical data, the IOL was perfectly in the sulcus supported by a remarkably thick anterior capsule. The capsulorhexis opening has changed into an oval one with a long axis almost the same as that of negative cylinder, 2 months later silicone oil was removed. The unaided vision of this eye returned to 0.9 to be corrected to 1.0 with +0.75 cylinder at 20.