Intravitreal luxated lens stuck on the optic disc: a case report

BACKGROUND: We encountered a rare patient with lens luxation in which the lens had become stuck on the optic disc. Findings obtained during vitreous surgery suggested that the luxated lens had become stuck on the optic disc via residual vitreous gel. CASE PRESENTATION: An 88-year-old Japanese man experienced lens luxation into the inferior vitreous cavity while undergoing treatment for glaucoma in his left eye. Because no inflammation was present upon examination, we observed the patient without prescribing any additional medications except for the eye drop treatment for glaucoma. Two years later, the patient revisited our clinic after suddenly noticing a visual disturbance in his left eye. A fundus examination revealed that the luxated lens had become stuck on the optic disc and displayed no changes in relation to the patient’s head position or eye movement. Subsequently, vitreous surgery was performed to remove the luxated lens. During the surgery, we observed an aggregation of vitreous gel between the luxated lens and the optic disc. The luxated lens was successfully mobilized by pushing with a vitreous cutter and then extracted through a corneoscleral incision using perfluorocarbon liquid. At 4 months after surgery, the patient’s visual acuity had improved to 20/25. CONCLUSIONS: The findings of this study suggest that the luxated lens had become stuck on the optic disc via residual vitreous gel on the optic disc. The surgical procedure of extracting the luxated lens through a corneoscleral incision using perfluorocarbon liquid was found to be both safe and effective.