Transcorneal extrusion of intraocular lens in severe dry eyes

Abstract

A 70-year-old man presented at the Advanced Eye Centre with diminished vision, pain, watering, and redness in the left eye of 6 months’ duration. He had undergone cataract surgery in this eye 1 year previously at another institution, with poor postoperative visual gain. There was also a history of multiple left eye epilations for trichiasis. On examination, left eye visual acuity was light perception, and the slit-lamp examination showed a vascularized corneal opacity along with an impression of a single-piece intraocular lens (IOL) on the corneal surface (A). On ultrasound biomicroscopy, there was a hyper-reflective shadow of the IOL in the corneal stroma, with the iris adherent to the corneal endothelium (B). The IOL was apparently extruding through the cornea because of chronic inflammation. The patient underwent keratoplasty, and his best-corrected visual acuity improved to 6/24.