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PURPOSE The purposes of this study are to report a case of adult-onset juvenile xanthogranuloma and suggest a new treatment option. METHODS A 35-year-old man presented with an isolated mass of the limbus. Biopsy revealed a histiocytic tumor with Touton's giant cells staining positive for CD68 and S-100 but negative for CD1a, consistent with JXG. Two intratumoral injections of triamcinolone acetonide 6 weeks apart were performed. The main outcome measure was 6-months follow up clinically and by ultrasound biomicroscopy. RESULTS The lesion regressed, and corneal thickness returned to normal 3 months after the first injection. An increase in intraocular pressure required topical treatment. No recurrence was seen throughout follow up. CONCLUSION Limbal juvenile xanthogranuloma can be successfully treated with intralesional triamcinolone acetonide, thus avoiding a lamellar keratectomy approach.

We present a patient with a history of posterior chamber intraocular lens (PC IOL) implantation and trabeculotomy 9 years previously who recently had IOL exchange for an angle-based anterior chamber IOL. Twenty-four hours after the exchange, he was referred to us with hypotony and "loss" of the IOL. Ultrasound revealed a rigid choroidal detachment and echoes suggestive of a suprachoroidally dislocated IOL. Anterior vitrectomy and resuturing of the incision were performed. Subsequently, the IOL repeatedly migrated in and out of the suprachoroidal space, allowing atraumatic removal. Angle-based IOL implementation should be avoided in eyes with a history of trabeculotomy or cyclodialysis.