What actually happens to an IOL in the first few hours and days after cataract surgery? Do they bounce around before settling in the 'capsular bag'?

An intraocular lens (IOL) or "lens implant" is needed to replace the aging and cloudy natural lens located immediately behind the pupil. Being very flexible and transparent, the IOL is rolled up in a specialized syringe and injected into the now empty "capsule" which the natural lens once occupied. A typical IOL is somewhat smaller in diameter, and considerably thinner than the natural lens, though. This is why there are "arms" on either side of the IOL (called "haptics") that will expand outwards into the periphery of the capsule, centering and stabilizing it. Within a few weeks, this clear, cellophane-like capsule will shrink and stick to the IOL, sealing it into place and pushing it slightly forward, flush with the pupil. This ends up creating a very stable and permanent attachment.

Until the process is complete, however, the IOL may "wobble" ever so slightly. And until the capsule shrinks and pushes the IOL forwards flush against the pupil, the very slight gap may produce a faint, curved shadow off to the side of a patient's vision. These are very common observations and not at all unexpected during the typical healing process.

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic