Abstract
A 72-year-old monocular male with no light perception in the left eye and a history of cataract extraction with polymethyl methacrylate (PMMA) intraocular lens (IOL) implantation and retinal detachment repair with scleral buckling in the right eye presented after a forward fall and hitting his face with a large iris defect, irregular pupil, superior zone 2 globe rupture, dense vitreous hemorrhage, and a 1-piece PMMA IOL dislocated in the posterior chamber in the right eye. His visual acuity on presentation was hand motion with directionality, with no improvement on pinhole. PMMA IOLs are difficult to cut and require larger incisions for removal, which was difficult in our patient with open-globe rupture. His large iris defect and minimal capsular support ruled out other options such as the implantation of a new IOL. IOL repositioning with scleral suturing resulted in the successful salvation of his IOL and visual acuity.
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