Implantable Collamer Lens in Management of Unilateral High Myopia After Pseudophakia for Traumatic Cataract: Piggybacking With Two Lenses in the Sulcus

Abstract

Purpose: To describe the management of unilateral high myopia after pseudophakia for traumatic cataract by piggybacking an Implantable Collamer Lens (ICL) (V4C ICL; STAAR Surgical) along with a primary intraocular lens (IOL) in the sulcus. Methods: A 24-year-old woman underwent lens aspiration with non-foldable IOL implantation in the sulcus at 5 years of age for post-traumatic cataract. She had regular follow-up for 21 years and developed unilateral high myopia. She was using contact lenses and wanted laser vision correction. An Implantable Collamer Lens in the sulcus was used to manage the unilateral high myopia in this pseudophakic patient with a rigid IOL in the sulcus. Results: Her corneal thickness was less than 500 µm. Except for raised intraocular pressure in the immediate postoperative period, she had uneventful postoperative recovery. Her uncorrected distance visual acuity (UDVA) at 4 weeks improved to 6/9. The patient was followed up for 7 months and had a UDVA of 6/9, intraocular pressure on Goldmann applanation tonometry of 14 mm Hg, adequate vault height (1.057 mm), good anterior chamber depth (1.739 mm), and no deposits on either of the lenses. Conclusions: An ICL can be used over a primary IOL in the sulcus for the correction of ametropia, although additional cases need to be evaluated for the proper sizing and results in similar patients. [ Journal of Refractive Surgery Case Reports. 2023;3(4):e42–e46.]