Decompensated cornea with epithelial and stromal edema

A 66-year-old patient underwent surgery for congenital cataract in both eyes in her first year of life without implantation of an intraocular lens (IOL). In 1994, at the age of 39 years, both eyes received secondary Kelman multiflex-style angle-fixated anterior chamber IOLs (AC IOLs). The surgeries were followed by retinal detachments in both eyes, in the left eye in the same year and in the right eye 4 years later, which were successfully repaired.The patient presented with a decompensated cornea with epithelial and stromal edema in the left eye. The AC IOL axis was oriented from 5-To 8-o'clock position with the haptic contacting the cornea. The distal portion of the inferior-nasal haptic was deeply buried and entrapped in a broad iridocorneal synechia extending between 6-And 8-o'clock positions. The synechia also caused adjacent pupillary distortion and pigment leaf eversion (Figure 1Figure 1.Left eye with decompensated cornea (after dehydration with glycerin) and angle-supported AC IOL. Inferonasal iridocorneal synechia encircles haptic and distorts and everts iris.). The AC IOL in the right eye was well positioned, and the cornea was clear with an endothelial cell count (ECC) of 2160 cells/mm²and central corneal thickness (CCT) of 650 m. No ECC was obtainable in the left eye, and CCT was 775 m (Figure 2Figure 2.Keratometry and pachymetry of the left cornea.). Visual acuity was 0.8 corrected in the right eye and hand motion in the left eye. Both eyes were normotonic.On optical coherence tomography (OCT) imaging, a broad iridocorneal synechia was visible with a canal corresponding to the deeply buried haptic end of the AC IOL (Figure 3Figure 3.SS-OCT displays broad iridocorneal synechia between the 6-o'clock and 8-o'clock positions with canal of grown-in haptic and pronounced Soemmerring's ring formation.). Abundant condensed cortical material (Soemmerring's ring) was found behind the iris and above the ciliary body.What