Severe intraocular lens opacification after scleral suturing in a patient with retinitis pigmentosa

Objective: To report a case of late intraocular lens (IOL) opacification after scleral suturing in a patient with retinitis pigmentosa. Methods: A 36-year-old man presented with visual impairment increasing gradually over the preceding three months. Seven years earlier, he underwent bilateral phacoemulsification cataract surgery with implantation of a Rayner 620H IOL in the left eye, and a Quatrix P12 IOL in the right eye. Five months prior to admission, scleral suturing of the subluxated IOL in the left eye was performed due to subluxation. Slit lamp examination revealed significant opacities within the IOL and marked vitreous floaters in the left eye. The previous diagnosis of retinitis pigmentosa and rotary nystagmus were confirmed. Subsequently, he underwent 25-gauge vitrectomy with IOL removal in his left eye. Light microscopy of the explanted IOL revealed unevenly distributed microvacuoles. Subsequently, vitrectomy with IOL removal was performed after 3 months in the right eye. Results: The patient had a good recovery of vision, with a visual acuity of 20/200 in both eyes with contact lenses. Conclusions: The presented case demonstrated a significant increase in IOL opacification following scleral suturing. The presumed pathogenesis includes IOL microdeformation with development of IOL matrix cavities and intense inflammatory response related to scleral suturing.