Aim and objective: We report the first case of bilateral cataract formation and pupillary block glaucoma and high intraocular pressure (IOP) following implantable Collamer lens (ICL) implantation that resulted in advanced visual field loss.
Background: The patient who underwent bilateral ICL implantation can develop bilaterally elevated IOP and an anterior subcapsular cataract with altitudinal visual field defect.
Case description: A 38-year-old man with high myopia presented for routine follow-up status post bilateral phakic ICL placement. The visual acuity was reduced due to an anterior subcapsular cataract and elevated IOP in both eyes with advanced glaucomatous visual field defects. The patient was treated with topical glaucoma medications. The left eye underwent same-day phakic ICL explanation and cataract surgery to prevent further visual field loss.
Conclusion: Cataract and glaucoma are serious complications after phakic ICL implantation; therefore, regular postoperative monitoring may prevent advanced visual impairment.
Clinical significance: The use of a phakic intraocular lens for the correction of myopia may result in complications. As a measure is to reduce such complications, refractive surgeons preferred using phakic posterior chamber intraocular Collamer lens for the correction of myopia.
Clara Y, Patel CK, Momont AC, et al. Advanced pigment dispersion glaucoma secondary to phakic intraocular collamer lens implant. Am J Ophthalmol Case Rep 2018;10:65–67. DOI: 10.1016/j.ajoc.2018. 01.046.
Sanders DR, Schenider D, Martin D, et al. Toric implantable collamer lens for moderate to high myopic astigmatism. Ophthalmology 2007;114(1):54–61. DOI: 10.1016/j.ophtha.2006.08.049.
Almalki S, Abubaker A, Alsabaani N, et al. Causes of elevated intraocular pressure following implantation of phakic intraocular lens for myopia. Int Ophthalmol 2016;36(2):259–265. DOI: 10.1007/s10792-015-0112-4.
The Implantable Contact Lens in Treatment of Myopia (ITM) Study Group. U.S. Food and Drug Administration clinical trial of the implantable contact lens for moderate to high myopia. Ophthalmology 2003;110(2):255–266. DOI: 10.1016/S0161-6420(02)01771-2.
ICL in Treatment of Myopia (ITM) Study Group. United states food and drug administration clinical trial of the implantable collamer lens (ICL) for moderate to high myopia; three-year follow-up. Ophthalmology 2004;111(9):1683–1692. DOI: 10.1016/j.ophtha.2004.03.026.
Sanders DR, Vukich JA. Incidence of lens opacities and clinically significant cataracts with the implantable contact lens: comparison of two lens designs. J Refract Surg 2002;18(6):673–682. DOI: 10.3928/1081-597X-20021101-03.
Sanders DR. Anterior subcapsular opacities and cataract 5 years after surgery in the visian implantable collamer lens: FDA trial. J Refract Surg 2008;24(6):566–570. DOI: 10.3928/1081597X-20080601-04.
Alfonso JF, Lisa C, Vega LF, et al. Prevalence of cataract after collagen copolymer phakic intraocular lens implantation for myopia, hyperopia, and astigmatism. J Cataract Refract Surg 2015;41(4): 800–805. DOI: 10.1016/j.jcrs.2014.07.039.
Mudr HK. Incidence of cataract following implantation of a posterior chamber phakic lens ICL (implantable collamer lens)–long-term results. Čes a slovOftal 2017;73:87–93.
Gonvers M, Bornet C, Othenin-Girard P. Implantable contact lens for moderate to high myopia; relationship of vaulting to cataract formation. J Cataract Refract Surg 2003;29(5):918–924. DOI: 10.1016/s0886-3350(03)00065-8.
Senthil S, Choudhari NS, Vaddavalli PK, et al. Etiology and management of raised intraocular pressure following posterior chamber phakic intraocular lens implantation in myopic eyes. PloS One 2017;12(2):e0172929. DOI: 10.1371/journal.pone.0172929.
McCaughey MV, Mifflin T, Fenzl CR, et al. Pseudophacomorphic glaucoma along with pupillary block after visian™ implantable collamer lens implantation for high myopia. Open J Ophthalmol 2014;4(4):107–111. DOI: 10.4236/ojoph.2014.44017.