title: Spontaneous bilateral anterior partial in-the-bag intraocular lens dislocation following routine annual eye examination.
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.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Ford
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Electronic address: liliana.werner@hsc.utah.edu.
authors.forename: Liliana
authors.initials: L
authors.lastname: Werner
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Owen
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Shail A
authors.initials: SA
authors.lastname: Vasavada
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Crandall
mesh_terms: D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000209:etiology* / Q000601:surgery; D017889:Exfoliation Syndrome / Q000150:complications; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D010808:Physical Examination; D012086:Reoperation; D012590:Sclera / Q000601:surgery; D013536:Suture Techniques