Transcorneal extrusion of an intraocular lens

An 82-year-old woman was treated for pseukophakic bullous keratopathy with a penetrating keratoplasty complicated by a postoperative retinal detachment. The retina was reattached successfully but impaired visual acuity remained. She was lost to follow-up for 14 months. Upon re-examination the pseudophakic lens optic had eroded completely through the donor cornea. Histologic study of the enucleated eye suggests that the intraocular lens optic came in contact with the posterior cornea after a transient wound dehiscence. The lens haptics, still attached to the optic, extended through anterior corneal scar tissue into the globe. The globe remained sterile and intact during the extrusion process. This case emphasizes the importance of selecting patients who will comply with postoperative care and the need to minimize contact between intraocular lenses and ocular tissue.