Ciliary Body Cysts Diagnosed After The Implantation Of An Implantable Collamer Lens (Icl)

To report a case of two hidden ciliary body cysts diagnosed after the implantation of an Implantable Collamer Lens (ICL).

Clínica Rementería, Madrid, Spain.

A 32-year-old man underwent a non-immediate sequential and uneventful bilateral ICL implantation for the correction of -7.00 diopters in both eyes (BE).At 1 day postop,the UDVA of the left eye (LE) was 1.2 and the ICL was well centered on the pupil with a vault grade II.In contrast,the UDVA of the right eye (RE) was 1.0 but the ICL was displaced temporally (vault grade II) with the KS-aquaPORT central hole located very near of the pupil edge.At the slit-lamp examination with bright light (inducing miosis), the AquaPORT was partially occluded by the iris. Intraocular pressure (IOP) was 12 mmHg in BE.Due to the risk of a pupil block,we decided to rotate vertically the ICL and recenter it. One day after,UDVA was 1.2 but the ICL continued to be slightly displaced temporally although the pupil, even with bright illumination, did not occlude the aquaPORT (IOP was normal). The ultrasound biomicroscopy (UBM) confirmed the presence of two hidden ciliary body cysts, one bigger at II o´clock (responsible of the temporal displacement of the ICL) and small one at VIII o´clock. A more exhaustive analysis of the different screens of the preop AS-OCT (Anterion) showed an anterior displacement of the peripheral iris at the II o´clock position,suggesting the presence of the inadvertent ciliary body cyst, responsible of the temporal displacement of the ICL. One year after the surgery, no additional displacement was detected and the IOP remained stable. 

In the preoperative examination before an ICL implantation, an AS-OCT is mandatory in order to analyze, not only the anterior chamber depth, angle-to-angle diameter, crystalline lens rise, but also the features of the iridocorneal angle and the iris morphology. An exhaustive analysis of the different screens of the AS-OCT could permit to detect asymptomatic iris and/or ciliary body cysts.