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 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.