Spontaneous repositioning of a subluxated posterior chamber intraocular lens.

Case Report A 60-year-old Chinese male, with no signifi cant medical history, underwent uncomplicated right phacoemulsifi cation surgery with a 5.5 mm capsulorrhexis and implantation of a single piece 4-loop aspheric acrylic PCIOL (Bausch & Lomb Akreos® Adapt AO,+20.0D, Rochester, NY, USA) into the capsular bag in March 2009. There was no zonular dialysis intraoperatively and no signifi cant capsular phimosis postoperatively. Preoperative axial length was 24.09 mm. Two years later, he presented with a 4-day history of right monocular diplopia. There was no history of trauma. His best corrected visual acuity (BCVA) was 6/9 in the right eye (refraction of -2.00DS/-3.25 DCx136°). An anteriorly subluxated and partially tilted in-the-bag PCIOL with a prolapsed superior haptic overlying the pupillary margin was noted (Fig. 1A). There was no PCIOL-cornea contact and no vitreous in the anterior chamber. The rest of the ocular examination was unremarkable. He was advised surgical repositioning of the subluxated PCIOL, but he chose to defer surgery. One month later, he reported spontaneous resolution of the diplopia. On examination, the PCIOL had spontaneously repositioned back into the posterior chamber (Fig. 1B). Mild pseudophacodonesis was noted. The BCVA was 6/6 (refraction of +0.25DS/-1.50DCx115°). Two years later, the PCIOL remained stable in the posterior chamber. No additional measures were taken to prevent dislocation.