ICL and Sequential Bilateral Pupillary Block

Chapter

Abstract

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.

Keywords

Permeability Glaucoma Refraction Cataract Neodymium 

References

  1. 1.
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    Apel A, Stephensen D (2007) Surgical management of acute angleclosure glaucoma after toric ICL implantation. J Cataract Refract Surg 33:1672CrossRefPubMedGoogle Scholar
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    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

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