A 57-year-old male patient presented to our clinic with a history of blurred vision in the right eye for 10 days. He had no recent systemic disease or ocular trauma history, but he remembered that blurred vision developed just after straining to lift a heavy object. His medical record showed that he underwent uneventful phacoemulsification with capsular bag implantation of a posterior chamber IOL in the right eye under local anesthesia 11 years ago in our institute. The IOL (model AQ2003V, STAAR® Surgical Co., Monrovia, CA, USA) was a three-piece biconvex lens with a 6.3-mm optic and polyimide haptics, and the overall diameter was 12.5 mm. The haptics had a C-shaped configuration and a flat angulation. Postoperatively, the uncorrected visual acuity (UCVA) was 20/20.\nAt presentation, the visual acuity of right eye was 20/60, and the intraocular pressure (IOP) was 11 mmHg by noncontact tonometer. Best corrected visual acuity (BCVA) was 20/20 (−2.25 Dsph = −1.00 Dcyl Ax 90). On slit-lamp examination, the pupil was distorted, and the IOL optic and a proximal part of a nasal fractured haptic were found in the anterior chamber, with cells 3+. After dilation, both ends of the fractured IOL haptic fragment were found to be aligned close to each other at the margin of the capsulotomy, with most of the haptic loop located in the bag []. Severe capsular fibrosis was also noted. Fundus examination revealed no specific abnormality. The corneal endothelial count was 2075/mm2 by specular microscope.\nTo prevent further complication, an operation was performed. Under retrobulbar anesthesia, the dislocated IOL including attached haptic fragment was removed. During operation, the fractured distal haptic fragment was noted and left in the bag. Then, a three-piece IOL (ZA9003, Tecnis®, Abbott Medical Optics, Santa Ana, IL, USA) was fixed in the ciliary sulcus. The extracted IOL was checked grossly, and the fracture site of the haptic was near the optic–haptic junction [].\nOn postoperative day 1, the UCVA was 20/25 and IOP was 10 mmHg. The IOL was fixed in the sulcus and postoperatively there were no further complications. At the most recent presentation, which was 3 weeks after operation, the UCVA was 20/25 and the IOL was well positioned.
A 57-year-old Asian male had initial right eye cataract surgery in 1998 at the age of 40 in Singapore. Background history included asthma and allergic rhinitis. He had an ocular history of right-sided Fuchs’ heterochromic iridocyclitis and secondary glaucoma. In 2002, approximately 48 months after his right eye PCIOL implant, the patient developed intermittent right-sided ocular inflammation. On examination, his vision was 6/6 and was found to have an in-bag superonasally displaced PCIOL, rubbing against the posterior surface of the iris and causing inflammation. In 2013, the PCIOL dislocated inferiorly. The patient underwent right eye PCIOL removal with pars plana vitrectomy and removal of IOL with secondary ACIOL placement. Postoperatively, his acuity was 6/6−2.