A-76-year-old Japanese woman complained of blurred vision in her left eye. She reported that she had undergone cataract surgery with an implantation of an IOL without any complications 8 years earlier. She also reported that she had been diagnosed with presumed sarcoidosis 15 years earlier in another University Hospital based on the Japanese diagnostic criteria. Although mild iritis, vitreous opacities, and peripheral multifocal chorioretinitis were present, the iritis was under control by topical steroids. She had undergone pars plana vitrectomy (PPV) with cataract surgery in an eye with mild vitreous opacities, an epiretinal membrane (ERM), and macular edema (ME) in another eye 12 years earlier. Since then, the ocular inflammation has been stable in both eyes.\nWhen she was referred to our hospital, her best-corrected visual acuity (BCVA) was 20/20 in the eye with the inferiorly subluxed IOL in her left eye (). The intraocular pressure (IOP) was 9 mmHg in the right eye and 10 mmHg in the left eye. Slit-lamp examination revealed no cells in the anterior chamber (AC). Pseudoexfoliation was not observed, but multifocal hyperpigmented chorioretinal atrophy was present in both eyes. After an increase of blurred vison to 20/25, she underwent 25-gauge pars plana vitrectomy in January 2011 during which the 3-piece acrylic IOL was displaced into a bed of intravitreal perfluorocarbon liquid (PFCL). The IOL was then removed through a 7.0-mm corneal scleral incision. A constriction of the capsule of the lens was not observed intraoperatively. A fornix-based conjunctival peritomy was made at 270 degrees followed by the construction of a partial thickness triangular limbal based scleral flaps 180 degrees apart. Then, a one-piece P336UV (Bausch and Lomb, Rochester, NY) was placed in the posterior chamber (PC) using the ab externo method with PAIR-PAKTM needles (Alcon Laboratory). Then, 10–0 polypropylene sutures were passed through the haptic eyelets and sutured to the sclera. The suture knots were buried under the scleral flaps, and scleral flaps were sutured with 8–0 vicryl sutures to avoid suture-related complications. Thereafter, the IOL was stable with minimal cells in the AC, and the BCVA has remained between 20/20 to 20/16 for 8 years (). Confluent pigmented chorioretinal atrophy was clearly observed postoperatively (). The visual field was constricted ().
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 ().