ICL and Sequential Bilateral Pupillary Block

  • Jaime Javaloy
  • Alessandro Abbouda


The refractive surgeon should be aware of the risk of pupillary block after Implantable Collamer Lens (ICL) implantation. If surgery before a neodymium:YAG (Nd:YAG) laser iridotomy is performed, the surgeon must be aware of the complete permeability of these iridotomies. The Visian Implantable Collamer Lens (ICL; STAAR Surgical) is a sulcus-placed, phakic, posterior chamber intraocular lens (PIOL) used to manage myopia, hyperopia, and myopic compound astigmatism in phakic patients [1, 2]. The ICL is designed to vault anteriorly to avoid contact with the crystalline lens. The vault is at risk of causing pupillary block; thus ICL surgery requires prophylactic placement of laser peripheral iridotomies. If the peripheral iridotomies are imperforate, pupillary-block angle closure can develop. Block can be treated with additional laser peripheral iridotomies [3, 4]. The new model of ICL surgery includes a small central hole to ensure adequate aqueous humor circulation, even in the absence of a peripheral iridotomy.


Anterior Chamber Slit Lamp Examination Crystalline Lens Anterior Chamber Depth Shallow Anterior Chamber 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Sanders DR, Vukich JA, Doney K, Gaston M, Implantable Contact Lens in Treatment of Myopia Study Group (2003) U.S. Food and Drug Administration clinical trial of the Implantable Contact Lens for moderate to high myopia. Ophthalmology 110:255–266CrossRefPubMedGoogle Scholar
  2. 2.
    Huang D, Schallhorn SC, Sugar A, Farjo AA, Majmudar PA, Trattler WB, Tanzer DJ (2009) Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology. Ophthalmology 116:2244–2258CrossRefPubMedGoogle Scholar
  3. 3.
    Apel A, Stephensen D (2007) Surgical management of acute angleclosure glaucoma after toric ICL implantation. J Cataract Refract Surg 33:1672CrossRefPubMedGoogle Scholar
  4. 4.
    Bylsma SS, Zalta AH, Foley E, Osher RH (2002) Phakic posterior chamber intraocular lens pupillary block. J Cataract Refract Surg 28:2222–2228CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Anterior Segment and Refractive SurgeryVissum Corporacion AlicanteAlacantSpain
  2. 2.Department of Refractive SurgeryVissum Corporación OftalmológicaAlicanteSpain
  3. 3.Department of Ophthalmology-Policlinico Umberto I of RomeUniversity of Rome “Sapienza”RomaItaly
  4. 4.R&D DepartmentVissum Corporación OftalmológicaAlicanteSpain

Personalised recommendations