Four-flanged prolene fixation for a toric trifocal intraocular lens of the double C-Loop design in an eye with severe capsular phimosis.

Purpose: To report a rare case of severe capsular phimosis after toric trifocal intraocular lens implantation, in a patient who was already on systemic immunosuppression and to present a modified fixation technique, based on the four-flanged prolene technique, which could be adapted for fixation of intraocular lenses of the double-C-loop design.

Observations: A 33 year old gentleman, who underwent uneventful, sequential, bilateral phacoemulsification with implantation of toric trifocal intraocular lenses, presented 6 weeks post-operatively, with severe capsular phimosis, causing decentration of the IOL and deformation of the haptics in both eyes. The left eye was successfully managed by Nd-YAG laser anterior capsulotomy, while the right eye required surgical intervention.