Accidental Corneal Intrastromal Intraocular Lens Implantation with the Wound-Assisted Technique and Clinical Course with Anterior Segment Optical Coherence Tomography

Abstract

Accidental intraocular lens (IOL) implantation into the corneal stroma is a rare clinical entity that can occur during the wound-assisted technique. In this report, we describe a case of an 81-year-old man who underwent cataract surgery in which the IOL was implanted into the corneal stroma with the wound-assisted technique, and we present changes in anterior segment optical coherence tomography. The IOL was removed and reinserted after widening the incision. Air tamponade was created by intracameral injection. An anterior chamber tap was performed 10 h later to reduce increased intraocular pressure. Interlayer separation of the corneal stroma was confirmed 30 min postoperatively but was corrected 4 days later. The patient's best-corrected visual acuity (BCVA) was logMAR 0.30, and he had been diagnosed with age-related macular degeneration before surgery. Although the opacity of the corneal stroma persisted, BCVA improved to logMAR 0. When using the wound-assisted technique for IOL insertion, surgeons should take care not to implant the IOL into the corneal stroma.