• Chen Li and Peirong Lu.
• Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
• Medicine (Baltimore). 2021 Jan 22; 100 (3): e24391.

RationaleOnly 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 ConcernsA 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.DiagnosisIOL surface foreign body.InterventionsAfter 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.OutcomesFortunately, 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).LessonsThis 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.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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