Anterior Chamber Intraocular Lens Exposure through Prelimbal Sclera: a Case Report

Purpose: To report a case of spontaneous exposure of anterior chamber intraocular lens in a patient with history of congenital cataract surgery ten years prior to presentation. Report of the case: A 27-year-old man presented with a two-year history of blurred vision, photophobia, mild ocular pain and redness in his left eye, with no history of prolonged eye rubbing, ocular surface disease or any evidence of trauma. On exam there was redness and swelling of the eyelids in the involved side; however, there was no evidence of any long standing ocular surface condition. Slit-lamp biomicroscopy disclosed an injected eye with haptic exposure of an angle-supported anterior chamber lens approximately 1 mm posterior to the limbus through the sclera. Anterior chamber was mildly inflamed and pupil was peaked towards the area of the exposed haptic. Ultrasound biomicroscopy revealed edematous and thickened sclera near the exposed tip. The dislocated lens was extracted and an iris-fixated anterior chamber lens was implanted instead. According to the size of the intraocular lens (IOL) and the white to white distance of the patient, it seemed that an incorrect selection of IOL size was the reason for the haptic exposure. Conclusion: We presented a rare case of spontaneous anterior chamber lens exposure and its surgical management in a patient with an otherwise healthy ocular surface. It was concluded that an error in IOL size selection might have been the cause of spontaneous haptic exposure.