Histopathologic findings in a transsclerally sutured posterior chamber intraocular lens

A 77-year-old woman had penetrating keratoplasty (PKP), removal of an anter ior chamber intraocular lens (IOL), and implantation of a transsclerally su tured posterior chamber IOL for painful pseudophakic bullous keratopathy. P ostoperatively, preexisting anterior synechias led to painful secondary ang le-closure glaucoma and the eye was enucleated 8 months after the PKP. Ligh t microscopy of the eye revealed that the haptics of the IOL were surrounde d by a variably dense fibrous membrane consisting of connective tissue and fibroblasts. In some areas, the haptics had eroded into the superficial str oma of the ciliary body. Except for rare foreign-body giant cells, no infla mmatory cells were present near the haptics. This case illustrates that hap tics of transsclerally sutured posterior chamber IOLs may be stabilized by fibrous membranes and/or by erosion into the ciliary body relatively soon a fter implantation. This should be considered if surgical centration, remova l, or exchange of such a lens is planned. (C) 2001 ASCRS and ESCRS.