A 65-year-old male was referred to the ophthalmology department by his optometrist after identification of an anteriorly dislocated posterior chamber IOL. The patient denied vision changes or other ocular symptoms. His past ocular history was significant for uncomplicated bilateral cataract surgery in 1993, twenty-three years prior to presentation. He denied any recent ocular or head trauma. Ten months prior to presentation, the patient underwent coronary artery bypass graft surgery which was complicated by postoperative cardiac arrest for which he required cardiopulmonary resuscitation, which included chest compressions.\nOn examination, the patient was noted to have an IOL dislocated into the anterior chamber of the right eye with inferior iris capture of the optic and a fractured inferior lens haptic as noted in Figure .\nOther findings included mild non-proliferative diabetic retinopathy in both eyes without macular edema. There was no evidence of pupillary block, intraocular inflammation, iris chafing, or vitreous prolapse. The patient’s visual acuity was 20/20 and the intraocular pressure was within normal limits. Given the lack of ocular symptoms and his unstable cardiac condition, observation with close follow up was recommended. The patient remained asymptomatic until five months later when he developed photophobia, hyperemia, and was found on examination to have intraocular inflammation with associated macular edema. Visual acuity in the eye at this time was 20/100. The implant's position had not changed since the previous visit. Due to his unstable cardiac status, surgical options were limited, and the patient was treated with three rounds of subtenon's triamcinolone acetonide (40mg) injections at six- to eight-week intervals along with topical prednisolone acetate 1% drops. Following cardiac clearance, the dislocated IOL was surgically explanted and the patient was left aphakic. The explanted lens was noted to be a three-piece flexible silicone lens with polyimide haptics. In the months following, the patient was noted to have complete resolution of intraocular inflammation and macular edema. His final best-corrected visual acuity was 20/20.
A-77-year old woman complained of blurred vision in her left eye. She had undergone cataract surgery with implantation of an IOL 13 years earlier without any complications. She had been diagnosed with presumed sarcoidosis about 15 years earlier, and the mild iritis had been controlled by steroid eyedrops.\nHer BCVA at presentation was 20/30 in the left eyes. The IOP was 15 mmHg and 14 mmHg in the right and left eyes, respectively. Slit-lamp examination revealed no cells in the anterior chamber, but a nasally dislocated in-the-bag IOL was detected (). Slit-lamp examination showed no pseudoexfoliation or vitreous opacities, and ophthalmoscopy showed pigmented chorioretinal atrophy in the periphery. The subfoveal EZ was disrupted in the OCT images.\nShe underwent 27-gauge PPV and the one piece in-the bag PMMA IOL was removed through a 7.5-mm corneal scleral incision without PFCL in September 2017. A CZ70BD IOL (Alcon, Texas, USA) was implanted and fixed with scleral sutures as in the other cases. Thereafter, the PC-IOL was stable (), and the BCVA has remained 20/30 for 2 years without obvious signs of iritis. The peripheral pigmented chorioretinal atrophy and mild macular degeneration could be clearly observed after the surgery (). The visual field was constricted due to the chorioretinal atrophy ().