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This is a patient who presented with the sudden onset of decreased vision due to a Z syndrome 5 weeks after her original Crystalens surgery. Her cataract surgeon treated her with Atropine and topical steroids for 2 weeks and then referred her to me for surgical management. I chose to exchange the lens for a Crystalens AO one diopter higher in power and to place a CTR. Her original clear cornea was at one O"clock and was inducing some cornea flattening contributing to her 1.7 diopters of astigmatism so this was revised and a scleral tunnel incision placed on the steep axis to reduce her astigmatism further. This was successful as the patient saw 20/25+2 uncorrected the first day with excellent positioning of her new implant.