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Images in clinical medicine

Spontaneous anterior dislocation of the intraocular lens after cataract surgery

Spontaneous anterior dislocation of the intraocular lens after cataract surgery

Aymane Ridallah1,&, Alae El Bouaychi1


1University Mohammed V Souissi, Ophtalmologie A ,l'Hôpital des Spécialités, CHU Rabat, Rabat, Maroc



&Corresponding author
Aymane Ridallah, University Mohammed V Souissi, Ophtalmologie A, l'Hôpital des Spécialités, CHU Rabat, Rabat, Maroc



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We report the case of a 35-year-old patient, an athlete by profession, who had a one-sided right-eye congenital cataract since childhood, for which he had a cataract surgery by phacoemulsification with the placement of an intraocular posterior chamber lens in the capsular bag; the surgery was carried out without complications. Fifteen days after the surgery, the patient performed a sports activity (running), during which he felt eye pain and decreased visual acuity, which motivated him to consult urgently. The examination found a clear cornea, a stretched pupil and a subluxed intraocular lens in the anterior chamber, with a lower corneal contact. The patient benefited from a surgical procedure, with a re-implantation of the implant in the bag; the postoperative follow-up was without particularities. Dislocation of the intraocular lens (IOL) is a rare complication and requires urgent surgical management. Different surgical techniques have been described: explantation alone, explantation followed by implantation of an anterior iridescent chamber lens, repositioning of the implant in the bag or sulcus and scleral fixation. The early dislocation, before 3 months, is due to an inadequate implantation of the IOL in the capsular bag, favored by a posterior capsular rupture, a broad zonular disinsertion; and the delayed dislocation, after 3 months, is part of a zonular insufficiency.



Figure 1: picture showing a flexible hydrophobic posterior intraocular lens subluxated in the anterior chamber with a lower corneal touch