A rare intraocular lens surface foreign body during phacoemulsification surgery A case report

Rationale: Only a few cases of intraocular lens (IOL) opacification during phacoemulsification surgery have been reported in the literature; intraoperative emergency due to IOL surface foreign body is even rarer. Patient concerns: A 76-year-old woman underwent uncomplicated cataract surgery in her right eye. A triangular transparent seemingly foreign body tightly attached to the posterior surface of the IOL was found during IOL implantation; the IOL surface foreign body prevented the patient from obtaining satisfactory visual acuity after surgery. Diagnosis: IOL surface foreign body. Interventions: After confirmation of the surface foreign body by swept-source optical coherence tomography (IOL Master 700), the surface foreign body was removed in a second surgery. After surgery, the IOL was still well centered. Outcomes: Fortunately, the patient achieved distinctly improved vision without any visual disturbances in her right eye. To identify the material of the foreign body, it was examined by Fourier-transform infrared spectroscopy (FTIR). Lessons: This case suggests that surgeons should carefully observe IOLs before implantation. In addition, effective preoperative planning and skillful surgery can remove foreign bodies smoothly and improve patient vision.