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When a posterior phakic lens is implanted upside down

Poster Details

First Author: M.Cigales SPAIN

Co Author(s):    J. Hoyos-Chacon   J. Hoyos-Campillo                 

Abstract Details


To present two cases of ICL implanted upside down.


Instituto Oftalmologico Hoyos.


Male patient with -9.5 D of myopia and 20/15 of vision. Anterior chamber depth (ACD) was 3.38 mm and white-to-white was 13 mm. We implanted ICL VICM013.7 of -11.5 D. One day after surgery uncorrected visual acuity (UCVA) was 20/40 and refractometer measured �.5 -3 X 88�Â�º. Second case is a female patient with -8.25 D of myopia, 20/15 of vision, 3.6 mm of ACD and 11.6 mm of white-to-white. The ICL implanted was VICM012.6 of -10 D. One day after surgery UCVA was 20/70 and refractometer measured �.5 -3 X 70�Â�º. ICLs were in contact with the crystalline lens.


Anterior OCT showed a lack of vault and the ICL shape suggested an inverted implantation. Checking the surgical video, we observed how the ICL turned during the insertion. The complication went unnoticed and the position of the holes in the haptics were not checked. Both ICLs were implanted upside down. We performed ICL explantation and implantation in the correct position. One day later UCVA was 20/20 and ICL had a good vault in both cases.


We need to take into account that intraoperative inversion can occur during ICL insertion. An early low vision with an inexplicably high mixed astigmatism could suggest this complication.

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