| 본문 : Dislocation of an intraocular lens (IOL) may occur in eyes after eyeball trauma. This mostly involves IOL subluxation or dislocation into the posterior area, penetration or expulsion of the IOL accompanied with distortion of the eyeball contour. However, subconjunctival dislocation of an IOL are rarely reported. Here, we report an interesting case of subconjunctival dislocation of intraocular lens through sclerocorneal tunnel incision after ocular trauma.
An 85-year-old female was referred after a fall which involved forehead laceration and blunt trauma to her left eye. Upon referral, the patient was initially described as aphakic status and vitreous prolapse with no information of her surgical history. Visual acuity was 0.7 OD and 0.02 OS . Intraocular pressure was 18 mmHg OD and 16 mmHg OS measured by rebound tonometer. Facial CT showed no evidence of orbital wall fracture and no definite irregularity in the eyeball contour. Fundus examination revealed vitreous hemorrhage. Anterior segment examination with slit lamp microscopy showed a hump of subconjunctival hemorrhage (SCH). Under careful examination the subconjunctival mass appeared to be an IOL placed under the conjunctiva. The conjunctiva was intact except for the presence of massive SCH. The patient underwent surgery for eyeball exploration and IOL removal. Intact one-piece IOL was removed for the subconjunctival space. No other break in the sclera was found besides the sclerocorneal incision from a previous cataract surgery. Therefore it can be speculated that the scleral incision site served as an outlet for the blunt trauma pressure, and the IOL was forced into the subconjunctival space. To the best of our knowledge, this is the first case to be reported in Korea, with few cases reported worldwide.
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