A 79-year-old Korean male with complaints of sudden decrease in visual acuity in the right eye was referred to our clinic. He did not present any remarkable medical history except hypertension. Phacoemulsification with capsular bag implantation of a posterior chamber IOL (AQ2003 V, STAAR Surgical Co., Monrovia, CA) was performed in both his eyes, about 10 years ago in a local clinic. Subsequently, Nd:YAG laser posterior capsulotomy was performed in the right eye at a local clinic. On ocular examination, the uncorrected distance visual acuity (UCVA) was 20/400 for the right eye and 20/20 for the left eye. The best-corrected distance visual acuity (BCVA) was 20/20 (x-10.00 Dsph) for the right eye and 20/20 for the left eye. Intraocular pressure (IOP) was 11 mmHg as measured by noncontact tonometer in the right eye. On slit-lamp examination, the cornea and conjunctiva were unremarkable, and there was no evidence of neovascularization in the iris, while dislocated IOL with intact anterior capsulorrhexis margin was observed in the right eye (Fig. ). We removed the dislocated IOL and fixed a 3-piece IOL (Acrysof MN60AC, Alcon Laboratories, Inc) in the ciliary sulcus under retrobulbar anesthesia. During the dislocated IOL removal operation, a fractured distal haptic was observed (Fig. ), and a proximal haptic was broken when held with a pair of smooth forceps (Fig. ). After the operation, the observed UCVA was 20/20 and the measured IOP was 18 mmHg; the IOL was fixed in the ciliary sulcus. The extracted polyimide haptic was fractured in vitro with 13 shots of 5.5 mJ energy (Fig. ). Patient has provided informed consent for publication of the case
An 81-year-old Caucasian male presented with long-standing right-sided multifocal choroiditis and retinal vasculitis complicated by choroidal neovascularization with a macular scar and bilateral moderate glaucoma. He developed progressive anterior and posterior subcapsular cataract. Preoperatively, the patient’s uveitis was controlled with topical steroids only. He underwent uncomplicated phacoemulsification cataract extraction with a 19.0D Alcon SN60WF in-bag implant in 2000. Postoperatively, his vision was initially 6/36. Due to his choroidal neovascular membrane, the vision in his right eye progressively deteriorated to light perception only by 2009. He represented in 2013 at the age of 80, 165 months after his initial right eye IOL implant, with in-bag dislocation of his PCIOL. He was managed conservatively due to the poor visual potential.