<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0864-2176</journal-id>
<journal-title><![CDATA[Revista Cubana de Oftalmología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Oftalmol]]></abbrev-journal-title>
<issn>0864-2176</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0864-21762022000400001</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Mal posicionamiento de háptica como causa de sorpresa refractivaastigmática]]></article-title>
<article-title xml:lang="en"><![CDATA[Haptic Poor Positioning as a Cause of Astigmatic RefractiveSurprise]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Córdova Crisanto]]></surname>
<given-names><![CDATA[José Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Loayza Gamboa]]></surname>
<given-names><![CDATA[Waldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valera Cornejo]]></surname>
<given-names><![CDATA[Diego Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alvarado Villacorta]]></surname>
<given-names><![CDATA[Rosa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera Quiroz]]></surname>
<given-names><![CDATA[Julio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Clínica Vista  ]]></institution>
<addr-line><![CDATA[ Lima]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Oftalmología  ]]></institution>
<addr-line><![CDATA[ Lima]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional Mayor de San Marcos  ]]></institution>
<addr-line><![CDATA[ Lima]]></addr-line>
<country>Peru</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Peruana Cayetano Heredia  ]]></institution>
<addr-line><![CDATA[ Lima]]></addr-line>
<country>Peru</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Asociación para Evitar la Ceguera en México I.A.P.  ]]></institution>
<addr-line><![CDATA[ Ciudad de México]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>35</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0864-21762022000400001&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0864-21762022000400001&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0864-21762022000400001&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Un resultado refractivo no esperado luego de una cirugía de catarata puede tener múltiples causas, ya sean preoperatorias, operatorias y posoperatorias. Como las más importantes se han descrito los errores en el cálculo biométrico en el preoperatorio y también las menos probables o infrecuentes como: inadecuada selección del poder del LIO, ausencia de precisión en la manufactura de los LIOs, intervención quirúrgica en paciente equivocado o en el ojo equivocado y el uso de un lente de contacto blando al momento de la biometría. Presentamos el caso de un paciente operado de catarata por facoemulsificación con implante de lente intraocular (LIO) monofocal plegable en saco capsular, que a los 30 días posoperatorios presentó un astigmatismo total o refractivo de - 1.00 dioptrías (D) x 110° pero a los 90 días de la cirugía, regresó por disminución de la agudeza visual con un astigmatismo refractivo de -5.50 D x 165° que no se relacionaba con el astigmatismo corneal medido por queratometría y topografía (-0.94 D x 82°). El ojo tenía medios transparentes y sin reportes de complicaciones posoperatorias inmediatas y mediatas. En este caso encontramos un mecanismo de inclinación del LIO provocado por una háptica deficientemente desplegada al momento de la inserción del LIO que no se evidenció en el acto quirúrgico asociado a desplazamiento de este, ocasionado por la fibrosis y contracción pupilar manifestando un efecto astigmático de manera tardía. Esto fue corroborado por ecografía con ultrabiomicroscopía y reposición quirúrgica del LIO logrando solucionar el caso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT An unexpected refractive outcome after cataract surgery may have multiple causes, whether preoperative, operative or postoperative. The most important ones have been described as errors in the preoperative biometric calculation and also the less probable or infrequent ones such as: inadequate selection of IOL power, lack of precision in the manufacture of IOLs, surgical intervention in the wrong patient or in the wrong eye and the use of a soft contact lens at the time of the biometry test. We present the case of a patient who underwent cataract surgery by phacoemulsification with a monofocal foldable intraocular lens (IOL) implantation in the capsular bag, who 30 days after the operation presented a total or refractive astigmatism of - 1.00 diopters (D) x 110°. Sometime later, 90 days after surgery, he returned due to decreased visual acuity with a refractive astigmatism of -5.50 D x 165° which was not related to the corneal astigmatism measured by keratometry and topography (-0.94 D x 82°). The eye had clear mediums and showed no reports of immediate and gradual postoperative complications. In this case we found a mechanism of IOL tilt caused by a poorly deployed haptic at the time of IOL insertion that was not evident at the time of surgery associated with IOL displacement caused by fibrosis and pupillary contraction, which generated a late astigmatic effect. This was corroborated by ultrasound with ultrabiomicroscopy and surgical repositioning of the IOL, which allowed the case to be solved.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[sorpresa refractiva]]></kwd>
<kwd lng="es"><![CDATA[astigmatismo]]></kwd>
<kwd lng="es"><![CDATA[facoemulsificación]]></kwd>
<kwd lng="en"><![CDATA[refractive surprise]]></kwd>
<kwd lng="en"><![CDATA[astigmatism]]></kwd>
<kwd lng="en"><![CDATA[phacoemulsification]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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