Corneal decompensation and graft failure secondary to a broken posterior chamber poly(methyl methacrylate) intraocular lens haptic

A 66-year-old man developed an unexplained corneal decompensation 7 years a fter extracapsular cataract extraction and implantation of a single-piece p oly(methyl methacrylate) (PMMA) posterior chamber intraocular lens (IOL). H e had penetrating keratoplasty (PKP). Two years later, he developed corneal graft failure secondary to an IOL haptic fragment in the anterior chamber angle. The patient had a repeat corneal graft and IOL exchange, The broken haptic was examined with scanning electron microscopy. The findings were co nsistent with late fracture of the haptic within the capsular bag, which wa s presumably weakened by an improper implantation technique. Fracture of a PMMA haptic should be suspected as a cause of corneal decompensation and co rneal graft failure after cataract surgery. This case emphasizes the import ance of safe implantation techniques. (C) 2001 ASCRS and ESCRS.