Pseudophacocele is defined as displacement of artificial lens which is implanted after cataract surgery in subconjunctival space. The number of cases reported worldwide is very less in number. This condition needs differentiation from phacocele. Blunt ocular trauma to post cataract surgery eyes can cause artificiallens dislodgement and fracture of inntraocular lens implant in subconjunctival space and other ocular regions.

Here we report a case of 40 year male who presented with complaints of diminution in vision, pain and redness in right eye following blunt trauma by cow’s horn 15 days back. He had history of cataract extraction with intraocular lens implantation 5 years back. On ocular examination a posterior chamber intraocular lens was seen in the anterior chamber with a broken haptic which migrated into subconjunctival space in the perilimbal area supero-temporally. He was managed with IOL explantation with implantation of sclera fixated IOL and repair of scleral wound.

Keywords: Pseudophacocele, Cow Horn Injury, Manual SICS, IOL Displacement, Blunt Trauma.

1. Biedner, B., Rothkoff, L. & Blumenthal, M. (1977). Subconjunctival dislocation of intraocular lens implant. Am J Ophthalmol; 84: 265-6.
2. Bene, C. & Kranias, G. (1985). Subconjunctival dislocation of a posterior chamber intraocular lens. Am J Ophthalmol; 99: 85-6.
3. Foster, J. A., Lam, S., Joondeph, B. C. & Sugar, J. (1990). Suprachoroidal dislocation of a posterior chamber intraocular lens. Am J Ophthalmol; 109: 731-2.
4. Sandramouli, S., Kumar, A., Rao, V. & Khosla, A. (1993). Subconjunctival dislocation of posterior chamber intraocular lens. Ophthalmic Surg; 24,:770-1.
5. Kumar, A., Nainiwal, S. K., Dada, T. & Ray, M. (2002). Subconjunctival dislocation of an anterior chamber intraocular lens. Ophthalmic Surg Lasers; 33,:319-20.
6. Chandravanshi, S. L., Dwivedi, A., Tirkey, E. R. & Choudhary, P. (2015). Golden half ring sign for identification of pseudophacocele. Indian J Ophthalmol; 63: 259-61. 10.4103/0301-4738.156931
7. Bawankar, P., Lahane, T. & Parekh, R. (2018). Pseudophacocele. Indian J Ophthalmol: 661191. 10.4103/ijo.IJO_323_18.
8. Bhattacharjee, K., Bhattacharjee, H., Deka, A. & Bhattacharyya, P. (2007). Traumatic phacocele: Review of eight cases. Indian J Ophthalmol; 55: 466-468.
9. Narang, P. &Agarwal, A. (2017). Clinical outcomes in traumatic pseudophacocele: A rare clinical entity. Indian J Ophthalmol; 65: 1465- 1469. 10.4103/ijo.IJO_1068_17
10. Bolling, J. P., Magargal, L. E., Shakin, E., Annesley, W. H., Jr., Sarin, L. K., Federman, J. & Robb-Doyle, E. (1986). Trauma to eyes containing posterior chamber lenses. Trans Pa Acad Ophthalmol Otolaryngol; 38: 307-10.
11. Bandyopadhyay R, Banerjee A, Bhaduri G, Singh M. Traumatic pseudophacocele. J Indian Med Assoc 2004;102:731.
12. Mandal AK, Anand R. Traumatic pseudophacocele. Indian J Ophthalmol 2003; 51:177‑8.
13. Joshi RS. Sub‑conjunctival dislocation of posterior chamber intra‑ocular lens: Five years after manual, small‑incision cataract surgery. Nepal J Ophthalmol 2014;6:91‑4.
14. Kubal WS. Imaging of orbital trauma. Radiographics 2008;28:1729‑39.
15. Correa ZM, Augsburger JJ. Ultrasound biomicroscopy of the anterior ocular segment. Duane’s foundations of clinical ophthalmology on CD‑Rom. In: Foundations. Vol. 2, Ch. 106. Philadelphia: Lippincott Williams and Wilkins; 2006.
16. Mackool R, Russell R. Strength of clear corneal incisions in cadaver eyes. J Cataract Refract Surg1996; 22:721-5.
17. Agrawal, R., Wei, H. S. & Teoh, S. (2012). Predictive factors for fi nal outcome of severely traumatized eyes with no light perception. BMC Ophthalmol; 12: 10.1186/1471-2415-12-16
18. Rao, L. G., Ninan, A. &Rao, K. A. (2010). Descriptive study on ocular survival, visual outcome and prognostic factors in open globe injuries. Indian J Ophthalmol; 58: 321-3. 10.4103/0301-4738.64116.

Dr Tanmay Srivastav

Regional Institute of Ophthalmology, Banaras Hindu University, Varanasi, India