Intraocular lens (IOL) opacification is rare but may occur after intra vitreal air or oil injection after pars plana vitrectomy (PPV). We reported two cases of IOL opacification within the pupillary region.

Chart was retrospectively reviewed. The predisposing factors and the visual acuity were analyzed. The opacification was evaluated by anterior segment optical coherence tomography (AS-OCT).

Case 1: A 66-year-old healthy woman with nearly mature cataract underwent phacoemulsification and IOL implantation in the right eye. Postoperative vision was 20/40. Seven months after surgery, fine granular deposits were seen in the anterior surface of IOL. The vision decreased to 3m count finger. Case 2: A 74-year-old woman with diabetes mellitus he presented with proliferative diabetic retinopathy, and vitreous hemorrhage received pars plana vitrectomy (PPV) and silicone oil tamponade 13 months after cataract surgery in the left eye. Granular deposits were observed in hydrophilic acrylic IOL 1 month after surgery. The visual acuity decreased to 1m count finger. AS-OCT revealed hyper reflective materials in the anterior surface of IOL in both cases.

An uncommon phenomenon of IOL opacification in the pupil region may occur after PPV, which may be associated with intraocular air or oil injection or systemic diseases.