A-76-year old Japanese woman complained of blurred vision in her right eye. She had undergone cataract surgery with an IOL implantation without any complications 12 years earlier. She had also undergone PPV for an ERM and ME in both eyes 8 years earlier. She was diagnosed with sarcoidosis approximately 15 years earlier in another general hospital by a skin biopsy. Oral prednisolone (dose unknown) had been initially prescribed for the vitreous opacities and ME. After the PPV, the uveitis was controlled by topical steroids.\nHer BCVA was 20/25, when she was referred to our hospital in March 2015. The IOP was 13 mmHg and 11 mmHg in the right and left eyes, respectively. Slit-lamp examination revealed no cells in the AC, but a superior subluxation of an in-the-bag IOL was detected (). No pseudoexfoliation or vitreous opacities were present, and pigmented chorioretinal atrophy was found in the peripheary. The foveal ellipsoid zone (EZ) was disrupted in the optical coherent tomographic (OCT) images.\nShe underwent 27-gauge PPV in May 2015. The dislocated 3-piece acrylic IOL was displaced into a pool of PFCL and cut into 3 pieces. The pieces were removed through a 3.5-mm corneal scleral incision. A foldable acrylic IOL (VA-70 AD, HOYA, Tokyo, Japan) was inserted and suture-fixed to the sclera with the ab externo technique as in Case 1. Although the PC-IOL was stable () and the BCVA improved to 20/20 after the surgery, the BCVA decreased to the baseline value at 4 years due to mild macular chorioretinal atrophy. Peripheral pigmented chorioretinal atrophy and mild macular degeneration were clearly observed after the surgery (). A peripheral hypofluorescent lesion was also observed in the fundus autofluorescence images which corresponded with the pigmented lesion ().
A 58-year-old female patient from Tambolaka, Southwest Sumba, Indonesia presented for a follow-up after mass cataract extraction surgery. She graduated from high school and lives as a farmer. Before undergoing mass cataract extraction surgery, she complained of blurred vision in both eyes for 1 year. Upon examination, best visual acuity after correction was 1/300 for the right eye and 1/60 for the left eye. There was no history of other ocular disease prior to surgery. The patient was diagnosed with bilateral mature senile cataract. She then underwent phacoemulsification surgery of her right eye on August 27, 2016 in a mass cataract surgery in the hospital using a regular foldable lens. One week after the surgical procedure, the patient came to the hospital for post-surgery checkup and complained of sudden blurred vision in her right eye. History of eye trauma was denied by the patient. She admitted that before the symptoms appeared, she had often carried heavy loads around 5–10 kg and drawn water from wells as her daily activities. Upon physical examination, blood pressure was 130/90 mm Hg and visual acuity of the affected right eye was 1/60. Ciliary injection was found in the right eye along with IOL in the anterior chamber (Fig. ). Another surgery was later performed on the patient to replace the dislocated IOL with a new one. During the second operation, the trailing haptic was found to be broken. Post-surgery visual acuity of the right eye was 6/21.