A 56-year-old man presented with a 15-day history of sudden, painless blurring of vision in his right eye.\nPrevious ophthalmic history included an uneventful MSICS (manual small incision cataract surgery) and successful extraction of a mature cataract with a foldable hydrophilic acrylic intraocular lens in the right eye 36 months before presentation.\nAt 1 month follow-up the patient had a visual acuity of 20/20 with –0.25 DS.\nAt 18 months after the surgery, the best corrected visual acuity (BCVA) decreased to 20/40 and in the slit lamp examination, a visually significant posterior capsular opacification was found with no other significant ocular finding. Nd: YAG capsulotomy was performed and BCVA of 20/20 achieved at an uneventful follow-up 10 days post procedure.\n17 months after capsulotomy the patient presented with painless diminution of vision. BCVA was 20/60. Slit lamp examination showed anterior in-the-bag intraocular lens dislocation (Figure 1 ). Intraocular pressure was 15 mm Hg. There were no abnormal findings in the fundus on examination by indirect ophthalmoscopy with 20D lens.\nIt was managed with intraocular lens explantation with bag, anterior vitrectomy and scleral fixated intraocular lens using scleral flap and four point technique.\nThird day follow-up was uneventful with visual acuity of 20/30 and one month follow-up with a best corrected visual acuity of 20/20 (Figure 2 ).\nFigure 3 shows the result a month after surgery. End result was uncomplicated pseudophakia at end of 6 weeks.
A 49-year-old Caucasian male presented with a dense right-sided cortical cataract in 2007 at the age of 44. HIV infection was diagnosed in 1997. His ocular history included bilateral keratoconus, bilateral uveitis, and multifocal choroiditis, which had been treated with eight intravitreal triamcinolone (IVTA) injections previously and was quiescent at the time of his cataract surgery. His right eye vision was 3/60 preoperatively. He underwent uncomplicated phacoemulsification cataract surgery and implantation of a 15.5D Alcon SN60WF into the bag. Postoperatively, his acuity improved to 6/12. Subsequently, he underwent right eye vitrectomy for long-standing vitritis in 2008. Seventy-five months after his initial PCIOL implant, he represented with visual loss in the right eye due to an in-bag IOL dislocation. He underwent a pars plana vitrectomy and removal of IOL. He was left aphakic and managed with a hard contact lens. On the last review in June 2014, his right eye corrected visual acuity was 6/7.5.