The aim was to describe a case of inadvertent posteriorly dislocated lens nucleus after intravitreal injection (IVI) for diabetic retinopathy, highlighting the importance of adherence to the standard protocol of IVI.
Case presentation: A 58-year-old female with uncontrolled type 2 diabetes mellitus presented with decreased vision bilaterally. At presentation, the anterior segment of both eyes showed nuclear sclerosis +2. Fundus examination of the left eye was not visible due to diffuse vitreous hemorrhage, for which an intravitreal ranibizumab injection was given. She presented for follow-up 3 weeks later; an aphakic left eye was discovered during the examination. A dropped nucleus was diagnosed, and the patient underwent an uneventful pars plana vitrectomy with removal of the dropped nucleus and implantation of a sulcus three-piece intraocular lens. Postoperatively, the vision had improved from hand motion to 6/18. Clinical discussion: this case presentation reports an unusual complication of a dropped lens nucleus after IVI. It highlights the possibility of inadvertent lens trauma in such a procedure and the importance of proper adherence to standards to avoid such a complication.
Conclusion: This rare complication highlights the importance of carefully following IVI guidelines in the hands of experienced ophthalmologists and the need for meticulous supervision for ophthalmology residents because it is not a risk-free procedure.
Keywords: case report; diabetic retinopathy; dropped nucleus; intravitreal injection; vitreous hemorrhage.
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