title: Bilateral spontaneous anterior dislocation of intraocular lens with the capsular bag in a patient with pseudoexfoliation.
abstract: We report a rare case of bilateral spontaneous anterior partial in-the-bag intraocular lens (IOL) dislocation in a 75-year-old man with pseudoexfoliation (PXF). He underwent uneventful phacoemulsification in both eyes with in-the-bag IOL implantation 9 years back. In the right eye, single piece poly (methyl methacrylate) (PMMA) IOL (+19 D) and in the left eye, single piece acrylic foldable IOL (+19 D) were implanted. An attempt at pharmacological IOL repositioning was unsuccessful. The dislocated IOLs were explanted and exchanged with scleral suture fixated PMMA IOLs. Vision improved to 20/30 in both eyes following surgery, without any associated ocular morbidity. We believe that zonular weakness secondary to PXF, capsular contraction, and myopia together were the predisposing factors for partial anterior dislocation of IOLs and IOL exchange with scleral suture fixation of IOL is a safe and effective treatment option.
authors.forename: Harsha
authors.initials: H
authors.lastname: Bhattacharjee
authors.affiliation: Department of Vitreoretina Services, Sri Sankardeva Nethralaya, Guwahati, Assam, India.
authors.forename: Rushil Kumar
authors.initials: RK
authors.lastname: Saxena
authors.forename: Jnanankar
authors.initials: J
authors.lastname: Medhi
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000473:pathology*; D060437:Artificial Lens Implant Migration / Q000209:etiology* / Q000601:surgery; D020878:Device Removal; D017889:Exfoliation Syndrome / Q000150:complications*; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006801:Humans; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D012086:Reoperation; D014065:Tonometry, Ocular