Sequential changes to intraocular lens dislocation caused by vigorous ocular massage: A case report

RATIONALE: Although intraocular lens (IOL) dislocations have been reported after uneventful cataract surgeries, no sequential changes have ever been demonstrated. Our case showed the sequential changes to IOL dislocation caused by vigorous ocular massage. PATIENT CONCERNS: A 42-year-old man complained of blurred vision in the left eye 8 years after uneventful phacoemulsification. The IOL was still well-centered, but curvilinear tears of the anterior and posterior capsule along the optic border of IOL and vitreous herniation were noted. In the following month, the IOL subluxated inferiorly. A careful history taking revealed a recent habit of vigorous ocular massage. The subluxation was stable for 2 years after avoiding ocular massage, but dislocation into vitreous occurred after taking a spring water bath (spa) bath with massage. DIAGNOSIS: IOL dislocation. INTERVENTIONS: Pars plana vitrectomy to remove the dislocated IOL and implantation of a 3-piece IOL into sulcus were performed. OUTCOMES: The IOL was well-centered. The visual acuity returned to 20/20. LESSONS: Ocular massage might cause tear of the intact fibrotic capsule and dislocation of IOL. The capsule along the border of the optics might be a weak point against ocular massage.