A 67-year-old woman examined 12 months following extracapsular cataract extraction had a massive pseudophakic pigment dispersion associated with diffuse corneal epithelial edema, mild uveitis, and secondary glaucoma. She underwent penetrating keratoplasty following removal of a posterior chamber intraocular lens (IOL), anterior vitrectomy, capsulectomy, and iris biopsy. Histopathologic examination revealed a pigmented iris nevus and signs of iris erosion by the IOL loop. Because 3 months later the eye developed streptococcal endophthalmitis and had to be eviscerated, we had the opportunity to examine the eye contents; we found no evidence of phakoanaphylactic uveitis.