Purpose Postoperative extrusion of an intraocular lens at a site unrelated to the surgical incision is a very rare complication. We report the case of a posterior chamber intraocular lens extrusion through the cornea eight years after a penetrating keratoplasty in a patient with spontaneous aseptic stromal melting. Observation A 77-year-old man was treated for pseudophakic bullous keratopathy with a penetrating keratoplasty complicated by chronic graft rejection and severe glaucoma. He referred to our emergency department eight years after the surgery. The examination showed that the pseudophakic lens optic had eroded completely through the donor cornea. The globe remained intact during the extrusion process. The patient underwent excision of the pre-intraocular lens tissue, removal of intraocular lens implant and capsular bag, liberation of synechia, anterior vitrectomy and corneal graft under general anesthesia. There was no complication during or after the surgery. Histologic study suggests that the intraocular lens optic was covered by conjunctival epithelium with malpighian metaplasia. Conclusion To our knowledge, it's the first case of posterior chamber intraocular extrusion through ocular tissues following penetrating keratoplasty. This case emphasizes the importance of early identification of risk factors, strong postoperative follow up and good patient compliance and the need to minimize drug and surgery-induced iatrogenic effects. If the complication does ensue, early surgical intervention may prevent or minimize serious damage.

Purpose: Although the Cochet-Bonnet esthesiometer (CBE) measures corneal sensitivity, it has heretofore only been tested on the index pulp. Tactile skin sensitivity thresholds are measured with Semmes-Weinstein monofilaments (SWM). This study measured skin sensitivity thresholds in healthy individuals using CBE and SWM, and compared both instruments in territories involved in corneal neurotization. Methods: Overall, 27 healthy individuals were tested by a single examiner at 9 territories on the face, neck, forearm, and leg, using 20-thread SWM and CBE with a diameter of 0.12 mm. Both sides were tested. Thresholds were compared for both instruments and between the different territories using Bayesian methods. Results: Mean sensitivity levels for SWM ranged from 0.010 to 1.128 g, while mean sensitivity levels for CBE ranged from 0.006 to 0.122 g. Thresholds measured with SWM were significantly higher than with CBE. Both instruments demonstrated higher thresholds in the leg territory than the forearm. However, the forearm presented higher thresholds than the head territories. No significant differences were found between the head territories themselves. Overall, right-side territories exhibited lower thresholds than left-side territories. Conclusions: We have reported the first mapping of skin sensitivity thresholds using CBE. Thresholds measured with CBE and SWM were coherent. The use of CBE on the skin is particularly relevant to the field of corneal neurotization.