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-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 ().