Correction Of Hyperopia Research Articles

Advances in the research of femtosecond laser-assisted lenticule intrastromal keratoplasty for the correction of hyperopia

Lenticule intrastromal keratoplasty (LIKE) was introduced clinically in the 1980s as a refractive surgery. With the advancements of femtosecond laser, LIKE has been significantly revitalized. Currently, femtosecond laser-assisted LIKE has been demonstrated to be a safe and effective surgical procedure to correct hyperopia, but the predictability is still a major limitation. In this article, we review the history, procedures, influencing factors of predictability and challenge of LIKE to provide reference for clinical practice of femtosecond laser-assisted LIKE.

Reasons for Explantations of Posterior Chamber Phakic Intraocular Lenses in 1,490 Eyes.

To investigate the reasons for the removal and/or exchange of posterior chamber phakic intraocular lenses (PCPIOLs) and the outcomes of these procedures. In this retrospective study, PCPIOL implantations performed between January 2015 and June 2023 in a single center were reviewed. The study group consisted of the files of eyes with removed and/or exchanged PCPIOL. Visual acuities, refraction errors, endothelial cell counts, and measurements of the vault before and after exchanges were recorded. Reasons for removal and/or exchange were evaluated. The tuck-and-pull technique was used in all explantations. Twenty-three of 1,490 eyes with PCPIOL implantation required removal and/or exchange. Of the explanted eyes, 17 were implanted with PCPIOLs for myopia (1.21% of all myopic corrections) and 6 were implanted with PCPIOLs for hyperopia (6.59% of all hyperopic corrections). The most common reason for removal and/or exchanges after implantation was inappropriate vault (10 of the 23 total removals and/or exchanges), followed by cataract development (7 of the 23 total removals and/or exchanges). A comparison of the biometric characteristics of eyes with PCPIOL removal and/or exchange due to inappropriate vault with other PCPIOL implantations showed that anterior chamber depth, PCPIOL length, and white-to-white distance were significantly higher in the group of explanted eyes (P < .05). All eyes with high vault in myopic patients had a 13.2- or 13.7-mm length PCPIOL. The main reason for PCPIOL removal and/or exchange is vault values outside the ideal limits and cataract development. Before ordering 13.2- and 13.7-mm long PCPIOLs, biometric data of both eyes and recommended PCPIOL sizes should be carefully reviewed. [J Refract Surg. 2024;40(11):e797-e803.].

Stability of Corneal Totopography after Correction of Hyperopia by FS-LASIK: 3 Years of Follow-up

Stability of Corneal Totopography after Correction of Hyperopia by FS-LASIK: 3 Years of Follow-up

Corneal Epithelial Remodeling After Hyperopic SMILE: A 4-Year Study.

The purpose of this study was to investigate dynamic changes in corneal epithelial thickness (ET) after hyperopic small incision lenticule extraction (SMILE). This observational study included 18 eyes of 16 patients who were scheduled for hyperopic SMILE. High-resolution spectral-domain optical coherence tomography and a custom image segmentation algorithm were applied to measure corneal dynamic ET over a central 6 mm area. ET was analyzed among different corneal sectors (central, pericentral, and peripheral) at baseline and multiple postoperative time points (1 day, 1 month, 6 months, 2 years, and 4 years). Correlation analysis was performed between ET changes and preoperative and intraoperative parameters. The mean spherical equivalent of hyperopia correction was +2.64 ± 1.00 D, and the average age of enrolled 16 patients was 32.4 ± 10.8 years. At the last follow-up, 72% of eyes kept or improved corrected distance visual acuity, with 2 eyes that lost 2 lines. 72% of eyes were within ±1.0 D of target refraction, and 56% were within ±0.5 D. Average ET decreased by 11.0% (5.9 ± 2.3 μm) from 53.2 ± 3.5 μm to 47.4 ± 4.2 μm 4 years postoperatively (P<0.001). The ET at center 2 mm decreased most significantly by 14.5% (7.9 ± 2.9 μm), followed by the pericentral area by 10.5% (5.6 ± 2.3 μm). ET and front corneal curvature stabilized 1 month after surgery. No correlation was found between refraction regression and ET changes. Hyperopic SMILE induced significant central ET thinning. ET remodeling in the 6 mm area stabilized after 1 month and did not underlie refractive changes.

Polypseudophakia: from "Piggyback" to supplementary sulcus-fixated IOLs.

Polypseudophakia, the concept of using a second intraocular lens (IOL) to supplement an IOL that has already been placed in the capsular bag, was first used as a corrective measure where the power requirement was higher than that of available single IOLs. Subsequently, the technique was modified to compensate for post-operative residual refractive errors. In these early cases, an IOL designed for the capsular bag would be implanted in the sulcus.Although these approaches were less than ideal, alternative means of correcting residual refractive errors were not without their limitations: IOL exchange can be traumatic to the eye and is not easily carried out once fibrosis has occurred, while corneal refractive surgical techniques are not suitable for all patients.Piggyback implantation was the term first coined to describe the use of two IOLs, placed together in the capsular bag. The term was later extended to include the procedure where an IOL designed for the capsular bag was placed in the sulcus. Unfortunately, the term piggyback has persisted even though these two approaches have been largely discredited.Intraocular lenses are now available which have been specifically designed for placement in the ciliary sulcus. As these newer IOLs avoid the many unacceptable complications brought about by both types of earlier piggyback implantation, it is time to employ a new terminology, such as supplementary IOL or secondary enhancement to distinguish between the placement of an unsuitable capsular bag IOL in the sulcus and the implantation of an IOL specifically designed for ciliary sulcus implantation.In addition to minimising possible complications, supplementary IOLs designed for the sulcus have expanded the options available to the ophthalmic surgeon. With these new IOLs it is possible to correct presbyopia and residual astigmatism, and to provide temporary correction of refractive errors in growing, or unstable, eyes. This article aims to review the literature available on supplementary IOL implantation in the ciliary sulcus and to summarise the evidence for the efficacy and safety of this intervention. KEY MESSAGES: What is known Polypseudophakia has been used for over 30 years to correct hyperopia or residual refractive error, but early techniques were associated with significant complications. What is new The development of specially designed sulcus-fixated supplementary IOLs significantly reduces the risks associated with these procedures, and has also opened up new opportunities in patient care. The reversibility of the procedure allows patients to experience multifocality, and to provide temporary and adjustable correction in unstable or growing eyes. The terms "secondary enhancement" or "DUET" to describe supplementary IOL implantation are preferential to "piggyback".

Factors influencing the therapeutic effect of hyperopic correction on esotropia in patients with partially accommodative esotropia.

To collate data on partially accommodative esotropia (PAET) to better understand this condition's aetiology and to evaluate and predict the therapeutic effect of a hyperopic correction on PAET. Eighty-nine consecutive patients diagnosed with PAET with a spherical equivalent (SE) refractive error >+2.50 D were included in this retrospective review. Clinical characteristics, including gender, age, SE, angle of esodeviation, accommodative convergence/accommodation (AC/A) ratio, near-distance disparity (NDD) and anatomical features of the rectus muscles were compared among different PAET subgroups. Multiple linear regression was used to identify independent factors that influenced the therapeutic effect of a hyperopic correction on esotropia. No significant differences were observed for the angle of esodeviation as a function of age in individuals with PAET. The incidence of SE in PAET participants >9 years old was significantly greater than in those <5 and 6-8 years of age. The therapeutic effect of hyperopic correction on esotropia was positively associated with SE both at distance and near. In addition, the limbus insertion distance (LID) of the lateral rectus (LR) muscle was positively associated with NDD at distance, but negatively associated at near. A greater incidence of hyperopia was observed in older (>9 years old) PAET patients. A hyperopic correction had a greater effect on esotropia in individuals with a higher SE, larger LID of the LR muscle and a smaller NDD.

Modeling of the results of laser correction of hyperopia by the methods of cluster and discriminant analysis

Modeling of the results of laser correction of hyperopia by the methods of cluster and discriminant analysis

A modified flying-spot laser eye-surgery platform for hyperopic correction

Laser corneal reshaping is an eye surgery utilizes UV lasers to modify a targeted corneal surface to correct vision disorders such as myopia, hyperopia and astigmatism. The most commonly used laser type in such treatment is a pulsed gas laser namely argon fluoride (ArF) excimer laser (193 nm). A mixture of Argon, Fluorine and high percentage of Neon gas is utilized for producing the required laser. However, the availability of Neon gas is currently very limited due to the existent Russian-Ukraine war as this region is considered the main supplier of pure Neon gas. The present work provides a novel alternative system for the commercially available corneal reshaping eye surgery devices with a special opening for entering the operational laser beam from external sources. The proposed system is a flying spot platform coupled with a solid state laser, that is a forth harmonic of Nd: YAG laser. The aperture in the system’s design enables it to take in the generated UV-laser beam (266 nm) from the external Nd: YAG laser source. The beam is then modified and directed at the treatment area. The device was tested for hyperopia laser profile algorithm on different targets. Furthermore, the hyperopia profile procedure was also applied to the ex-vivo rabbit eye to investigate the ablation effect on the corneal tissues. The obtained results showed an appropriate ablation effect for hyperopic correction via a complete corneal reshaping platform. Although, the device’s current state may not be appropriate for immediate clinical use. It holds significant value as a training and educational platform.

Femtosecond laser-assisted in situ keratomileusis versus small-incision lenticule extraction: current approach based on evidence.

Laser keratorefractive surgery achieves excellent visual outcomes for refractive error correction. With femtosecond laser, small incision lenticule extraction (SMILE) is an increasingly viable alternative to laser-assisted in situ keratomileusis (LASIK). Comparative studies demonstrate similar efficacy and predictability between SMILE and LASIK, making it difficult for clinicians to choose which to use. This review thus compares femtosecond-LASIK (FS-LASK) and SMILE in various scenarios, to assist clinicians in deciding which refractive surgery procedure to recommend. SMILE may be superior for highly myopic eyes due to a smaller decrease in functional optical zone. SMILE further induces less spherical aberration and less overall higher order aberrations in mesopic conditions. SMIILE also has less postoperative dry eye, making it suitable those with preexisting dry eye. For low to moderate myopic astigmatism correction, FS-LASIK has less undercorrection compared to SMILE. Lastly, SMILE has not yet received Food and Drug Administration or Conformité Européenne approval for hyperopic correction, rendering FS-LASIK the choice of procedure for hyperopic correction. Both FS-LASIK and SMILE demonstrate good efficacy and predictability. Understanding specific clinical scenarios where one may be superior to the other will aid clinicians in choosing the most suitable procedure for personalized care.

The use of digital devices and changing habits among generation alpha in Hungary

AbstractPurposeThe aim of the study was to analyse the use of digital devices among children.Materials/MethodsA specially designed questionnaire was distributed to 249 schoolchildren to assess their use of digital devices both in school and outside school. The questionnaire was used before the start of the COVID-19 pandemic. The children were asked about the extent of their use of digital devices, as well as about ophthalmic and general health complaints. Their responses were assessed statistically.ResultsRegarding age distribution, 145 children were between seven and 10 years old when they started to use digital devices. Most of the children used a digital device for between one and two hours a day. The majority preferred using smartphones. The second most popular devices were laptops and tablets, and the third most popular was the desktop computer. Fifty-six children wore glasses, 14 to correct hyperopia and 42 to correct myopia. 97 children spent between one and two hours a day outdoors; 99 children spent more than two hours outdoors; and 51 spent less than one hour outdoors. 71 children reported eye problems; 48 reported other general health problems (back and neck pain); and 43 mentioned blurred vision while using a digital device.ConclusionsThe use of digital devices can be regarded as general among schoolchildren, and most children use a digital device for longer than the recommended time. Excessive use of digital devices may contribute to an increase in the prevalence of myopia and other general eye and back problems.

The correction of a hyperopic astigmatism with full-toric orthokeratology lenses. Clinical case

Orthokeratology has gained widespread clinical application in the last decade due to accumulated scientifi c data confi rming its effectiveness in inhibiting progressive myopia in children and adolescents. In cases of correction of other refractive errors, such as hypermetropia, mixed astigmatism, specialists inform patients about the possibilities of orthokeratology lenses (OKL) not often. This clinical case demonstrates the possibilities of customized, full-toric OKL to correct complex hyperopic astigmatism in an 11-year-old child. The patient was observed for several years with complex hyperopic astigmatism in ophthalmological clinics and followed the recommendations of specialists to use eyeglass correction. At the stage of transition from preschool to primary school, the child became shy of glasses and refused to wear them. In search of an alternative method of correction, parents sought advice in the special contact lens practice. The patient underwent a complete ophthalmological examination, including corneal topography. Taking into account the features of refraction and the shape of the cornea, the wishes of the child and parents, we have chosen customized orthokeratology lenses (OKL) with a fully toric design (full-toric) as method of correction. The OKL parameters were calculated by using the RGP Designer program. The lenses were made by OKVision Laboratory (Moscow). The fi tting of customized OKL allowed us to solve several tasks at once: the correction of complex hyperopic astigmatism and the freedom from using correction tools in the daytime. Despite the fact that orthokeratology is not the fi rst-line choice for optical correction of hyperopia, in some cases the method may become the only alternative to glasses and soft contact lenses

Refractive Surgery Overview

Advancements in technology and techniques are continuously shaping the field of refractive surgery for the correction of myopia, hyperopia, astigmatism, and presbyopia. As a result, more patients are seeking alternatives to spectacles or contact lenses. Clinicians must stay up-to-date with the latest options available for vision correction. This article aims to provide a comprehensive overview of the exciting progress being made in this area of clinical advancements and research.

Lenticule Intrastromal Keratoplasty for the Correction of Iatrogenic High Hyperopia.

The aim of this study was to evaluate the safety, efficacy, and predictability of lenticule intrastromal keratoplasty (LIKE) for the correction of iatrogenic high hyperopia. Three patients (4 eyes) were referred to our department because of overcorrection of myopia induced by femtosecond laser-assisted in situ keratomileusis. All eyes exhibited hyperopia (between +4.00 and +8.00 D) and thin corneas ranging from 307 to 378 μm. Because of the regression of the use of laser ablation to correct high hyperopia and thin corneas, we initially adopted LIKE to correct iatrogenic high hyperopia in all 4 eyes. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, corneal topography, and anterior segment optical coherence tomography findings were recorded during each follow-up evaluation. No postoperative complications, such as interface haze and opacification, were observed in the 4 eyes during each follow-up evaluation, with an average follow-up of 9.50 months. All eyes had significantly improved UDVA postoperatively. A total of 3 eyes achieved an UDVA of 20/25 or better while the other 1 eye had an UDVA of 20/40 postoperatively. In addition, 2 of the 4 eyes had a postoperative UDVA equal to or better than preoperative CDVA. No eyes lost any CDVA lines. All 4 eyes were within ±0.50 D of the spherical power (intended target of 0). The central corneal thickness and curvature of the anterior corneal surface in all 4 eyes increased postoperatively. Anterior segment optical coherence tomography revealed that the lenticule was transparent, with no wrinkles or offsets, during each follow-up evaluation. LIKE for the correction of iatrogenic hyperopia has good efficacy and safety. Although an extremely thin cornea after overcorrection may not be suitable for hyperopic laser enhancement, LIKE is a good choice because of its good predictability and ability to restore the normal corneal structure.

Comparison of Conventional Versus Trans-Epithelial Photorefractive Keratectomy in Hyperopia Treatment: A Contralateral Study

Background: This study was planned to compare Trans - epithelial Photorefractive Keratectomy (TPRK) and Alcohol Assisted Photorefractive Keratectomy (AAPRK) laser vision correction in hyperopia and compound hyperopic astigmatism.&#x0D; Methods: This quasi-experimental study was conducted on patients with hyperopia and hyperopic-astigmatism, whose eye laterality was randomly assigned to undergo TPRK versus AAPRK using SCHWIND AMARIS 1050RS (SCHWIND eye-tech-solutions, Germany). Follow up time was 1, 3, 6 and 12 months after surgery.&#x0D; Results: 112 eyes of 56 patients with mean age of 32.6 years included, of which 51.8% were female and 48.2% were male. Both TPRK and AAPRK methods were able to correct hyperopia and astigmatism safely and efficiently (p&lt;0.05 in all cases). Postoperative vision characteristics were similar in both methods (p=0.23 for sphere, p=0.52 for cylinder, p=0.064 for axis, and p=0.35 for BCVA) postoperatively. Corneal haze was observed in 44% of the patients with a direct strong correlation with hyperopia severity (r=0.607). Post-operative pain was observed in 60% of the patients with a direct weak correlation with hyperopia severity (r=0.27). Mild photophobia was seen in 42% of the patients with a direct weak correlation between photophobia and hyperopia severity (r=0.36). Epithelial healing time lasted an average of 3.48 days and there was a direct and moderate correlation with hyperopia severity (r=0.4). Safety index in TPRK and AAPRK was 0.54 and 0.45, respectively, with no significant difference (p=0.42); Efficacy index was 0.96 and 0.9 in TPRK and AAPRK, respectively and there was no significant difference between two groups (p=0.23). No complication was observed in all of the patients.&#x0D; Conclusion: TPRK and AAPRK laser vision correction are both safe and efficient in hyperopia and compound hyperopic astigmatism. There is no significant difference regarding epithelial healing time, post-operative pain and haze formation between two procedures.

Prescribing patterns for paediatric hyperopia among paediatric eye care providers.

To survey paediatric eye care providers to identify current patterns of prescribing for hyperopia. Paediatric eye care providers were invited, via email, to participate in a survey to evaluate current age-based refractive error prescribing practices. Questions were designed to determine which factors may influence the survey participant's prescribing pattern (e.g., patient's age, magnitude of hyperopia, patient's symptoms, heterophoria and stereopsis) and if the providers were to prescribe, how much hyperopic correction would they prescribe (e.g., full or partial prescription). The response distributions by profession (optometry and ophthalmology) were compared using the Kolmogorov-Smirnov cumulative distribution function test. Responses were submitted by 738 participants regarding how they prescribe for their hyperopic patients. Most providers within each profession considered similar clinical factors when prescribing. The percentages of optometrists and ophthalmologists who reported considering the factor often differed significantly. Factors considered similarly by both optometrists and ophthalmologists were the presence of symptoms (98.0%, p = 0.14), presence of astigmatism and/or anisometropia (97.5%, p = 0.06) and the possibility of teasing (8.3%, p = 0.49). A wide range of prescribing was observed within each profession, with some providers reporting that they would prescribe for low levels of hyperopia while others reported that they would never prescribe. When prescribing for bilateral hyperopia in children with age-normal visual acuity and no manifest deviation or symptoms, the threshold for prescribing decreased with age for both professions, with ophthalmologists typically prescribing 1.5-2 D less than optometrists. The threshold for prescribing also decreased for both optometrists and ophthalmologists when children had associated clinical factors (e.g., esophoria or reduced near visual function). Optometrists and ophthalmologists most commonly prescribed based on cycloplegic refraction, although optometrists most commonly prescribed based on both the manifest and cycloplegic refraction for children ≥7 years. Prescribing patterns for paediatric hyperopia vary significantly among eye care providers.

Effects of various hyperopia intervention levels on male college students' gait kinematics.

Background: Hyperopia is a common blurred vision phenomenon that affects postural control in gait; however, current research has focused on the alteration and correction of hyperopia's physiological characteristics, ignoring the effect of hyperopia on gait kinematic characteristics. The effect of hyperopia on the basic form of movement walking is a worthy concern. Objective: To investigate the gait kinematic characteristics of male college students with varying degrees of visual acuity (normal vision, hyperopia 150°, and hyperopia 450°), as well as to provide a theoretical foundation for the effect of visual acuity on gait and fall risk reduction. Methods: Twenty-two male college students with normal visual acuity were chosen. Their vision was tested using a standard visual acuity logarithm table at normal and with 150° and 450° concave lenses. Gait kinematic data were collected under normal vision and hyperopic conditions using the PN3 Pro advanced inertial motion capture system and Axis Studio application program. Results and conclusion: 1. The change of center of gravity in Pre-double support was smaller than normal vision; Late-single support and Late-swing was larger than normal vision; 2. The percentage of the double-leg support decreased; the percentage of the single-leg support and the Late-swing increased; 3. For the joints' range of motion, Trunk flexion and extension range of motion in Pre-single support, Late-double support and Pre-swing smaller than normal visual acuity, and Late-swing larger than normal; hip internal abduction and adduction and internal and external rotation are larger than normal vision in Late-single support; knee and ankle in abduction and adduction direction are larger than normal vision in the swing stage; hip flexion and extension, internal external rotation are larger than normal vision in the swing stage. Hyperopic interventions have an impact on the kinematic characteristics of gait in male college students, mainly in terms of altered balance, increased instability, increased difficulty in maintaining trunk stability, and increased risk of injury.

Transepithelial Photorefractive Keratectomy for Hyperopia Correction: An Uncharted Territory.

Transepithelial photorefractive keratectomy (Trans PRK) is a relatively new technology for refractive surgery and has shown promising results in myopia correction. The data on hyperopia correction by this method are limited. In this review, we have attempted to understand the outcomes of this technology on hyperopic eyes. There are comparable results with conventional PRK and laser in situ keratomileusis (LASIK) as far as refractive stability, regression rate, predictability, and post-operative complications are concerned. The best results have been obtained in lower hyperopic corrections. In moderate to higher hyperopia, the limited data available show higher regression, unstable visual outcomes, and increased stromal haze. There is a need to evaluate the technology further to understand its success for hyperopic refractive surgery.

Corneal biomechanical changes after myopic and hyperopic laser vision correction

Laser vision correction became a popular method of refractive error treatment. The laser vision correction techniques influence the corneal biomechanical properties including corneal hysteresis and corneal resistance factor. The ocular response analyzer and Corvis ST devices are used in clinical practice to measure the corneal biomechanics. Reasonable laser treatment planning, taking into account the impact on corneal biomechanics, may potentially improve the safety of the refractive procedures. Thicker caps in refractive lenticule extraction and thinner flaps in flap-related procedures promote better corneal biomechanics preservation. The myopic refractive treatment appears to have a greater effect on corneal biomechanics weakening than hyperopic correction.

Twelve-month outcomes of single-step transepithelial photorefractive keratectomy for moderate hyperopia and hyperopic astigmatism

BackgroundConventional mechanical or alcohol-assisted photorefractive keratectomy (PRK) techniques for correction of hyperopia and hyperopic astigmatism were associated with inconsistent results. The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia and hyperopic astigmatism. MethodsThis is a prospective interventional study. Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction (SEQ) between 2.0 and 4.5 diopters (D) underwent single-step StreamLight® TE-PRK using EX500 excimer laser (Alcon Laboratories, USA). The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution (logMAR) uncorrected and corrected distance visual acuity (UDVA, CDVA), cycloplegic refraction, corneal topographic changes as well as post-PRK peripheral haze grading.ResultsThe mean preoperative cycloplegic SEQ was significantly reduced from 3.21 ± 0.61 D to 0.35 ± 0.04 D and 0.41 ± 0.04 D at 6 and 12 months, respectively (P < 0.001). The mean preoperative UDVA significantly improved from 0.53 ± 0.02 logMAR to 0.07 ± 0.01 logMAR and 0.08 ± 0.01 logMAR at 6 and 12 months, respectively (P < 0.001) while the mean preoperative logMAR CDVA showed non-significant change over time throughout the study (P = 0.135). At the end of the study, 41 eyes (85.4%) achieved UDVA of 20/25 or better and no eye lost any lines of CDVA. Thirty-eight eyes (79.1%) had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months. The mean preoperative mean keratometry showed significant increase at 6 and 12 months postoperatively (P < 0.001) while there was no significant change between the two postoperative visits denoting topographic stability (P = 0.058). The mean postoperative Q value at 6 and 12 months showed a significant prolate shift (P < 0.001). No haze was observed in 62.5% and 85.4% of the enrolled eyes at 6 and 12 months, respectively.ConclusionsSingle-step StreamLight® TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes.Trial registration: (Clinicaltrials.gov): NCT05261685, 2 March 2022, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05261685

ICL Explant Due to Ocular Hypertension, Reduced Endothelial Cell Count and Anterior Sub Capsular Cataract Due to Patient Selection Error

Implantable Collamer Lenses (ICL) are phakic lenses that are implanted in the posterior chamber of the eye for the correction of myopia, hyperopia, and astigmatism in those patients who cannot undergo corneal refractive surgery, the main feature of the latest models. Of ICL is a hole in the optical center of the lens, which facilitates the natural flow of aqueous humor. Among the contraindications for ICL implantation are: Corneal pathologies, cataracts, glaucoma, retinal pathologies such as degenerations or detachments, diabetic retinopathy, patients allergic to collagen, pseudo-exfoliative syndrome, pigment dispersion syndrome, pupillary abnormalities, endothelial count less than 2000 mm2, uveitis, under 20 years of age or with unstable refraction. We present the case of a 24-year-old female patient who came to the clinic for refractive surgery due to high myopia, an ICL -18.00 D implant was proposed in the left eye. In the preoperative examinations: the UBM presented an iris plateau with multiple angle-closing cysts. In the optic nerve OCT she presents a moderate and severe decrease in nerve fibers and the visual field with PHG: outside normal limits, MD: -12.84 dB. After the postoperative period, the patient presented with ocular hypertension that was controlled with antihypertensive, he achieved IOP control a month after the operation, but after a few months postoperatively he presented a low endothelial cell count and an anterior sub capsular cataract, for which it was decided to explant the ICL. Finally, cataract surgery was performed and a monofocal IOL was implanted.