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Urrets-Zavalia syndrome after iris-claw phakic intraocular lens implantation and Its management: case report

Poster Details

First Author: A.Santos PORTUGAL

Co Author(s):    J. Ferreira   D. Amado   J. Cunha        

Abstract Details


A fixed and dilated pupil (Urrets-Zavalia Syndrome) is an uncommon postoperative complication after iris-claw phakic intraocular lens (IOL) implantation. Although the clinical features have been well described, the precise etiology is uncertain and iris ischemia seems to be the common physiopathologic event. The authors aim to present a case repor with review of literature.


C.H.L.C. - Centro Hospitalar de Lisboa Central, Department of Ophthalmology


The authors describe a clinical case of unilateral Urrets-Zavalia syndrome after iris-claw phakic IOL implantation and its management.


A 27-year-old woman with high myopia had unilateral anterior chamber iris-claw phakic IOL implantation under local anesthesia, without intraoperative complications. The preoperative slitlamp examination was normal and she had no past medical history. On the second day post-operatory, she developed fixed dilated mydriasis in her left eye with IOL subluxation. There had been no history of high intra-ocular hypertension and no mydriatic drops were used before, during, or after the procedure. We removed the left IOL and observed for six months after adapting contact lens. During this time she complained about glare, photophobia and developed contact lens intolerance. We decided to implant posterior chamber Implantable Collamer® Lens (ICL) and to perform iris cerclage in the left eye. After three weeks of follow-up she has no glare or photophobia and, on examination, the visual acuity is 20/30 in her left eye, with normal intra-ocular tension and a good aesthetic appearance of the iris.


Urrets-Zavalia syndrome is a rare but disturbing complication of phakic IOL. Posterior chamber ICL implantation with iris cerclage seems to be a simple and effective approach to this situation. FINANCIAL DISCLOSURE?: No

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