Possible protection of the posterior segment by a phakic intraocular lens

A 39-year-old man was referred with complaints of pain, redness, and reduced vision in the left eye after projectile trauma during hammering. Two years previously, anterior chamber phakic intraocular lenses (pIOLs) had been implanted to correct the patient's high myopia. On presentation, the best corrected visual acuity was 20/30 in the right eye and 20/50 in the left eye. Slitlamp examination disclosed a central self-sealed corneal laceration in the left eye, and gonioscopy and a high-resolution computed tomography scan showed a metallic intraocular foreign body (IOFB) lodged in the anterior chamber angle. After the foreign body was removed, the patient regained his previous visual acuity. In this case, the pIOL may have prevented further penetration of the IOFB and protected the crystalline lens and posterior segment.