Rationale: To report the first case of lens dislocation and secondary acute angle-closure glaucoma (AACG) following use of a percussion massage gun (PMG) around the eye.Patient concerns: A 69-year-old Chinese man had been using a PMG around his right eye for 2 months in order to relieve headache. After eye pain and blurred vision for 5 days, he went to the ophthalmological emergency department. His bestcorrected visual acuity at distance was counting fingers. Diagnosis:The patient was diagnosed with lens subluxation, secondary AACG and pterygium in the right eye. Cataracts were diagnosed in both eyes. Interventions:The patient underwent phacoemulsification and anterior vitrectomy. After surgery, the patient was given eye drops containing tobramycin, dexamethasone, 0.1% bromfenac sodium hydrate ophthalmic solution and Mydrin-P for 1 month.Outcomes: At 3-month follow-up, uncorrected visual acuity in the right eye was counting fingers. The outcome of optometry in the right eye was +11.50 DS/−0.50 DC * 110°, with corrected-distance visual acuity of 4/20. IOP was 20.7 mm Hg in the right eye and 15.7 mm Hg in the left. Endothelium in the right cornea showed endothelial damage. Nevertheless, the patient reported no right eye pain anymore, and he indicated that he was satisfied with his situation.Lessons: Caregivers, sports professionals and the general public should be aware of the dangers of PMGs and the need to use them appropriately and safely, for example during self-massage and rehabilitation therapy. In particular, we recommend not using PMGs above the neck, which should be clearly indicated in instruction manuals.Abbreviations: AACG = acute angle-closure glaucoma, AS-OCT = anterior segment optical coherence tomography, IOP = intraocular pressure, PMG = percussion massage gun, UBM = ultrasound biomicroscopy.

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IntroductionWe report a case of a man with cataract and anterior megalophthalmos (AM), in which some myopia was retained when calculating intraocular lens (IOL) power using the Haigis formula to avoid postoperative farsightedness.Case descriptionA 59-year-old Chinese man was referred to our clinic for cataract surgery in his right eye. He had strong bilateral megalocornea, and his left eye had undergone surgery four times. After complete preoperative examinations and repeated biometry, the Haigis formula was used, and a 3-piece IOL was implanted with a target power of −1.97 D. At 1-year follow-up, the patient showed the best-corrected distance vision of 20/20 with the refraction of −1.50 DC × 160°, and the IOL was stable.ConclusionOur patient with anterior megalophthalmos showed postoperative hyperopia drift even though the Haigis formula was used as suggested in previous studies. To prevent farsightedness after surgery, some myopia should be retained when calculating IOL power. The Kane, Holladay II with AL adjustment, and Barrett Universal II formulas may be more accurate for calculating IOL power in such patients.