The dead bag syndrome has recently been described as a cause of late spontaneous intraocular lens (IOL) subluxation and / or dislocation. The capsular bag remains clear years after surgery and then becomes diaphanous and floppy. The authors explanted seven capsular bags and five IOLs for histopathologic and microscopic examination. The capsular bags were clear with no cortical material. Six of them showed capsular splitting while the seventh bag showed thinning only. Lens epithelial cells (LECs) were completely absent (two cases) or rarely found (five cases). The explanted IOLS were three-piece silicone lenses or single-piece hydrophobic acrylic lenses. The lenses were unremarkable under light microscopy except for one IOL with a small amount of granular pigment deposition in the periphery. The authors differentiate dead bag syndrome from true exfoliation by the younger age group (average age of 65.7 vs. 75.2 years respectively) and the absence of history of exposure to infrared radiation or high heat. Also, cases of true exfoliation showed varying amounts of LECs. Further, there was no clinical or histopathological evidence of pseudoexfoliation material in any of the dead bag cases.