Bilateral explantation of Visian Implantable Collamer Lenses secondary to bilateral acute angle closure resulting from a non-pupillary block mechanism.
OBJECTIVE
To report a case of bilateral non-pupillary block angle closure glaucoma after Visian Implantable Collamer Lens (ICL, STAAR Surgical) surgery.


METHODS
A 35-year-old woman with high myopia, white-to-white measurements of 11.8 mm in the right eye and 11.9 mm in the left eye, and anterior chamber depths >3 mm in both eyes underwent simultaneous bilateral ICL implantation with 13.2-mm lenses.


RESULTS
Persistent, bilateral acute angle closure developed despite multiple patent peripheral iridotomies and iridectomies. Visante anterior segment optical coherence tomography (AS-OCT, Carl Zeiss Meditec) revealed profound vaulting of the ICLs and angle closure. Both ICLs were explanted. After explantation, ultrasound biomicroscopy demonstrated a sulcus-to-sulcus diameter of 10.8 mm in the right eye and 11.2 mm in the left eye.


CONCLUSIONS
The correlation between white-to-white and sulcus-to-sulcus measurements were poor in this patient, resulting in extreme vaulting of the ICL and angle closure from a non-pupillary block mechanism. Proper identification of the mechanism of angle closure is aided by AS-OCT. For non-pupillary block mechanisms, ICL extraction is necessary.
Khalifa
Yousuf M
YM
Flaum Eye Institute, University of Rochester, Rochester, NY, USA.
Goldsmith
Jason
J
Moshirfar
Majid
M
D000208:Acute Disease; D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology; D020878:Device Removal; D005260:Female; D007839:Functional Laterality; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D032801:Iridectomy; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D033401:Microscopy, Acoustic; D047728:Myopia, Degenerative / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D041623:Tomography, Optical Coherence