A 66-year-old male presented with a three-month history of subacute painless decreased vision in the left eye. His ocular history included complicated phacoemulsification surgery of the left eye more than 20 years prior to the presentation. Slit lamp examination revealed a retained lens nuclear fragment in the superonasal quadrant. Surgical removal of the lens nuclear fragment improved the patient's condition. The retained lens nuclear fragments were presumably lodged behind the iris during the phacoemulsification surgery and spontaneously displaced downward due to liquefaction of the vitreous body with age. To the best of our knowledge, this case involves one of the longest reported time periods from phacoemulsification surgery to the clinical presentation of retained lens material without causing inflammation. We recommend detailed ocular assessment post complicated phacoemulsification surgery to ensure that no lens materials are retained.
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