J Korean Ophthalmol Soc.  2023 Jan;64(1):73-77. 10.3341/jkos.2023.64.1.73.

Traumatic Posterior Chamber Intraocular Lens Dislocation into the Subconjunctival Space

• Lee HW
• Shin JH
• Lee Ju
• Park GS
• Kim KN
• Hwang YH

• KMID: 2539412
• DOI: http://doi.org/10.3341/jkos.2023.64.1.73

Abstract

Purpose
Here we report a case of posterior chamber intraocular lens (IOL) dislocation into the subconjunctival space (pesudophacocele) following ocular trauma.
Case summary
A 66-year-old male presented with ocular pain and decreased vision in the right eye following trauma with a metallic rod. The patient had a history of trabeculectomy, glaucoma drainage device implantation, transscleral cyclophotocoagulation, and cataract surgery for uveitic glaucoma and a cataract in the right eye. On examination, vision was hand movement, the intraocular pressure was 3 mmHg, and subconjunctival hemorrhage and hyphema were observed. After the resolution of hemorrhage, uveal tissue prolapse was seen nasally behind the corneal limbus and the IOL was found to be dislocated into the nasal subconjunctival space. There were no changes in the filtering bleb and tube compared to the pre-trauma status. The IOL was removed through a conjunctival incision because the patient refused any active treatment.
Conclusions
Pesudophacocele developed in a patient who had a history of glaucoma and cataract surgery in the injured eye. The IOL could not be assessed immediately after the trauma because of subconjunctival hemorrhage and hyphema. When the status of IOL is unclear or suspected to be dislocated after trauma, the possibility of pseudophacocele should be considered, in addition to the dislocation into the vitreous cavity.

Keyword

Dislocation, Intraocular lens, Trauma