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
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 ().