A 57-year-old Asian male had initial right eye cataract surgery in 1998 at the age of 40 in Singapore. Background history included asthma and allergic rhinitis. He had an ocular history of right-sided Fuchs’ heterochromic iridocyclitis and secondary glaucoma. In 2002, approximately 48 months after his right eye PCIOL implant, the patient developed intermittent right-sided ocular inflammation. On examination, his vision was 6/6 and was found to have an in-bag superonasally displaced PCIOL, rubbing against the posterior surface of the iris and causing inflammation. In 2013, the PCIOL dislocated inferiorly. The patient underwent right eye PCIOL removal with pars plana vitrectomy and removal of IOL with secondary ACIOL placement. Postoperatively, his acuity was 6/6−2.
A 45-year-old Caucasian male presented with right eye cataract secondary to previous bilateral uveitis in 2008 at the age of 39. Background history includes type 2 diabetes diagnosed in 2011. Ocular history included herpetic keratouveitis with bilateral acute retinal necrosis diagnosed in 2006 (now quiescent) and bilateral relapsing remitting macular oedema treated with multiple IVTA injections. His preoperative right eye vision was counting fingers, and he underwent an uncomplicated phacoemulsification with a 19.0D Alcon SN60WF PCIOL inserted into the bag. Postoperatively, the patient continued to have intermittent severe macular oedema and received three further right eye IVTA injections between 2008 and 2013. His right eye vision has improved to 6/9 by February 2013; however, some right eye PCIOL dislocation was noted. Sixty-four months after his initial PCIOL implant, the patient was found to have right eye in-bag PCIOL dislocation and a vision of 6/24−1 in June 2013. Two months later, he underwent a right-sided anterior approach IOL extraction and secondary anterior chamber IOL implantation. On last review, his right eye vision was 6/36.