Spontaneous bilateral anterior partial in-the-bag intraocular lens dislocation following routine annual eye examination

J Cataract Refract Surg. 2014 Sep;40(9):1561-4. doi: 10.1016/j.jcrs.2014.07.008.

Abstract

We present the case of an 81-year-old man with pseudoexfoliation syndrome (PXF) in whom spontaneous bilateral anterior partial in-the-bag intraocular lens (IOL) dislocation was diagnosed following a routine dilated examination that demonstrated only mild pseudophacodonesis with no evidence of subluxation. Uneventful cataract surgery with placement of single-piece hydrophobic acrylic posterior chamber IOLs had been performed in both eyes 7 years previously. Bilateral IOL repositioning with scleral fixation was performed to correct the dislocation. Postoperative examinations showed remarkable improvement in visual acuity and IOL stability. We hypothesize that zonular weakness secondary to PXF predisposed the patient to bilateral IOL partial dislocation. Pupil dilation in the setting of mild pseudophacodonesis at the time of routine examination may have been a precipitating factor. To our knowledge, bilateral IOL subluxation/dislocation has been described in a limited number of case reports.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Artificial Lens Implant Migration / etiology*
  • Artificial Lens Implant Migration / surgery
  • Exfoliation Syndrome / complications
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Phacoemulsification
  • Physical Examination*
  • Reoperation
  • Sclera / surgery
  • Suture Techniques