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Traumatic dislocation of implanted collamer phakic lens: a case report and review of the literature.

Moshirfar M, Stagg BC, Muthappan V, Vasavada SA - Open Ophthalmol J (2014)

Bottom Line: Three years prior, he had undergone bilateral ICL placement for high myopia.The patient had an associated hyphema that was medically managed, and 2 weeks after the injury, the patient underwent ICL repositioning.All patients who suffer blunt dislocation of ICL should be followed long-term after repositioning for signs of endothelial loss and dysfunction.

View Article: PubMed Central - PubMed

Affiliation: John A. Moran Eye Center, University of Utah School of Medicine, USA.

ABSTRACT

Purpose: Present a case of dislocation of an Implantable Collamer Lens (ICL) that occurs after blunt trauma and review the published literature on this topic.

Methods: Case report and literature review using PubMed.

Results: A 44 year-old male presented to the emergency department with sudden onset of blurry vision after blunt trauma to the left eye. Three years prior, he had undergone bilateral ICL placement for high myopia. On examination, the superotemporal haptic was noted to be dislocated into the anterior chamber, but there was no endothelial touch by the dislocated lens. The patient had an associated hyphema that was medically managed, and 2 weeks after the injury, the patient underwent ICL repositioning. A review of the literature was performed and five previous cases of ICL dislocation were identified. Three of these occurred after blunt trauma. One of these cases was associated with endothelial touch and decompensation and eventually required a descement's stripping endothelial keratoplasty (DSAEK).

Conclusion: Dislocation of ICLs after blunt trauma is a rare but important potential sequela of the procedure and can lead to corneal decompensation if there is lens-endothelial touch. All patients who suffer blunt dislocation of ICL should be followed long-term after repositioning for signs of endothelial loss and dysfunction.

No MeSH data available.


Related in: MedlinePlus

Slit lamp photograph of traumatic ICL dislocation.Superotemporal footplace dislocated into the anterior chamber withassociated peaking of the pupil at the edges of the lCL.
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Figure 1: Slit lamp photograph of traumatic ICL dislocation.Superotemporal footplace dislocated into the anterior chamber withassociated peaking of the pupil at the edges of the lCL.

Mentions: A 44 year-old man presented to the emergency department with blurry vision in the left eye after being struck in the eye with a pipe. The patient had bilateral ICLs placed for high myopia three years prior to presentation and had no previous complications associated with this surgery. The patient reported mild pain associated with brow and lid abrasions from the injury. In the left eye, his visual acuity at presentation was hand motions and intraocular pressure (IOP) was 22. He had 4+ red blood cells in the anteriorchamber (AC) with a blood clot located inferiorly. The superotemoporal haptic of the ICL was dislodged into the AC and entrapped in the pupillary aperture; the remaining haptics were behind the iris (Fig. 1). There was associated pigment clumping on the ICL. Fundoscopic exam revealed no abnormalities. There was no endothelial touch by the prolapsed ICL. The patient’s right eye visual acuity (VA) was 20/20 and had no abnormalities on examination other than a shallow vault between the lens and the ICL (50% of corneal thickness).


Traumatic dislocation of implanted collamer phakic lens: a case report and review of the literature.

Moshirfar M, Stagg BC, Muthappan V, Vasavada SA - Open Ophthalmol J (2014)

Slit lamp photograph of traumatic ICL dislocation.Superotemporal footplace dislocated into the anterior chamber withassociated peaking of the pupil at the edges of the lCL.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4066362&req=5

Figure 1: Slit lamp photograph of traumatic ICL dislocation.Superotemporal footplace dislocated into the anterior chamber withassociated peaking of the pupil at the edges of the lCL.
Mentions: A 44 year-old man presented to the emergency department with blurry vision in the left eye after being struck in the eye with a pipe. The patient had bilateral ICLs placed for high myopia three years prior to presentation and had no previous complications associated with this surgery. The patient reported mild pain associated with brow and lid abrasions from the injury. In the left eye, his visual acuity at presentation was hand motions and intraocular pressure (IOP) was 22. He had 4+ red blood cells in the anteriorchamber (AC) with a blood clot located inferiorly. The superotemoporal haptic of the ICL was dislodged into the AC and entrapped in the pupillary aperture; the remaining haptics were behind the iris (Fig. 1). There was associated pigment clumping on the ICL. Fundoscopic exam revealed no abnormalities. There was no endothelial touch by the prolapsed ICL. The patient’s right eye visual acuity (VA) was 20/20 and had no abnormalities on examination other than a shallow vault between the lens and the ICL (50% of corneal thickness).

Bottom Line: Three years prior, he had undergone bilateral ICL placement for high myopia.The patient had an associated hyphema that was medically managed, and 2 weeks after the injury, the patient underwent ICL repositioning.All patients who suffer blunt dislocation of ICL should be followed long-term after repositioning for signs of endothelial loss and dysfunction.

View Article: PubMed Central - PubMed

Affiliation: John A. Moran Eye Center, University of Utah School of Medicine, USA.

ABSTRACT

Purpose: Present a case of dislocation of an Implantable Collamer Lens (ICL) that occurs after blunt trauma and review the published literature on this topic.

Methods: Case report and literature review using PubMed.

Results: A 44 year-old male presented to the emergency department with sudden onset of blurry vision after blunt trauma to the left eye. Three years prior, he had undergone bilateral ICL placement for high myopia. On examination, the superotemporal haptic was noted to be dislocated into the anterior chamber, but there was no endothelial touch by the dislocated lens. The patient had an associated hyphema that was medically managed, and 2 weeks after the injury, the patient underwent ICL repositioning. A review of the literature was performed and five previous cases of ICL dislocation were identified. Three of these occurred after blunt trauma. One of these cases was associated with endothelial touch and decompensation and eventually required a descement's stripping endothelial keratoplasty (DSAEK).

Conclusion: Dislocation of ICLs after blunt trauma is a rare but important potential sequela of the procedure and can lead to corneal decompensation if there is lens-endothelial touch. All patients who suffer blunt dislocation of ICL should be followed long-term after repositioning for signs of endothelial loss and dysfunction.

No MeSH data available.


Related in: MedlinePlus