Anterior segment optical coherence tomography (AS-OCT, Optovue) showed ICL vault of 675μ in the RE and 998μ in the LE a. Gonioscopy showed open angles up to scleral spur in the RE and LE showed 270 0 peripheral anterior synechiae. At presentation, patient was on topical Pilocarpine Hydrochloride 2%, Brimonidine tartarate 0.2%, Timolol maleate 0.5% combination in LE. Slit lamp vault of the ICL was approximately 2 times CT. ICL was in place with optic capture at the pupillary border at 4 o'clock a. In the LE, cornea was clear, AC was quiet with PACD of ¼ CT. ICL was in place with a slit lamp vault of 1 CT. Pupil was 3 mm, round, regular and reactive a. Slit-lamp evaluation of RE showed clear cornea with peripheral anterior chamber depth (PACD) of ½ corneal thickness (CT). At presentation, uncorrected visual acuity (UCVA) in her right eye (RE) was 20/20, N6 and that of (LE) was 20/30, N6. Hence, a similar-sized nontoric ICL of 13.2 mm size was implanted in BE by the referring primary surgeon.
The preoperative reports showed that BE had a similar white-to-white (WTW) measurement of 11.8 mm and anterior chamber depth (ACD) of 3.1 mm in BE.
The preoperative refractive error was -5 D in BE. We describe for the first time, an interesting case of anisocoria secondary to the optic capture of ICL and a high vault, which was managed by rotation of the ICL and single pass four throw pupilloplasty.Ī 27-year-old female presented to our clinic with the complaints of glare and intolerance to light in her left eye (LE) after an ICL (STAAR V4C model) implantation in both eyes (BE) done 3 months back, elsewhere. There have been a few case reports of fixed and dilated pupil after Implantable collamer lens (ICL) implanation. Available from: įixed and dilated pupil after an intraocular surgery is a rare complication which is termed as Urrets Zavalia Syndrome (UZS). Management of anisocoria and high vault in an eye with implantable collamer lens.
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How to cite this URL: Srirampur A, Mansoori T, Balijepalli P, Gadde AK. How to cite this article: Srirampur A, Mansoori T, Balijepalli P, Gadde AK. Keywords: Implantable collamer lens, pupilloplasty, Urrets-Zavalia syndrome This case highlights a successful outcome of rotation of a nontoric ICL to reduce the high vaulting and optic capture along with single-pass four throw pupilloplasty. Postoperatively the ICL vault and the pupil size decreased and patient was asymptomatic. Single-pass four throw pupilloplasty was performed for the fixed dilated pupil. After thorough evaluation and ruling out the ICL sizing error, the optic capture was relieved and the ICL was rotated into vertical position. A young lady presented with very high vault and fixed dilated pupil along with optic capture of the implantable collamer lens (ICL).
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