ESCRS - CC12 - SUCCESSFUL MANAGEMENT OF SEVERE HYPEROPIA IN A 14-YEAR-OLD USING A POSTERIOR CHAMBER TORIC PHAKIC LENS: EVIDENCE FROM 52 MONTHS OF FOLLOW-UP

SUCCESSFUL MANAGEMENT OF SEVERE HYPEROPIA IN A 14-YEAR-OLD USING A POSTERIOR CHAMBER TORIC PHAKIC LENS: EVIDENCE FROM 52 MONTHS OF FOLLOW-UP

Published 2026 - 30th ESCRS Winter Meeting

Reference: CC12 | Type: Case Report | DOI: 10.82333/vtmf-p695

Authors: Kepa Balparda* 1 , Tatiana Herrera-Chalarca 2 , Mariana López-Velásquez 3 , Alejandro Jaramillo-Mejía 4 , Mariana Escobar-Giraldo 5

1Department of Cornea and Refractive Surgery,Private Practice,Medellín,Colombia, 2Department of Legal Affairs,Black Mammoth Surgical,Medellín,Colombia, 3School of Medicine,Universidad CES,Medellín,Colombia, 4School of Medicine,Fundación Universitaria San Martín,Medellín,Colombia, 5Department of Ophthalmology,Universidad Pontificia Bolivariana,Medellín,Colombia

Purpose

To describe the long-term outcomes of bilateral toric hyperopic posterior chamber phakic intraocular lens (ICL) implantation in a 14-year-old patient with severe hyperopia, illustrating its safety, stability, and psychosocial benefits after 52 months of follow-up.

Setting

High-volume refractive surgery clinic in Medellín, Colombia

Report of case

A 14-year-old girl presented with high hyperopic astigmatism and marked psychological distress caused by bullying over her thick spectacles, leading to suicidal ideation. Cycloplegic refraction measured +9.00 (+2.25 × 75°) OD and +9.00 (+2.00 × 110°) OS. She was intolerant to contact lenses and unsuitable for laser or lens-exchange surgery. After thorough counselling and informed consent, bilateral implantation of toric hyperopic ICLs (STAAR Surgical) was performed under general anaesthesia.

Surgery was uneventful. At three months, uncorrected distance visual acuity (UDVA) was 20/25 OD and 20/40 OS with stable refraction. At 52 months, UDVA remained 20/30 OD and 20/40 OS; lenses were well centred, anterior chambers deep, iridectomies patent, and crystalline lenses clear. Intraocular pressure and endothelial counts were normal, with no cataract, pigment dispersion, or ICL rotation. The patient achieved complete spectacle independence and reported a profound improvement in self-esteem and social functioning, with full resolution of depressive symptoms.

Conclusion / Take home message

This case demonstrates that, in carefully selected adolescents, toric hyperopic posterior chamber phakic IOLs can provide safe, long-term correction of extreme hyperopia while preserving accommodation and ocular anatomy. The 52-month follow-up confirms excellent refractive stability and anatomical integrity. Beyond visual rehabilitation, the psychological impact was transformative, emphasising the role of compassionate refractive surgery in restoring quality of life. Although off-label, this approach may represent a valuable therapeutic option when conventional treatments are unsuitable, provided strict ethical and surgical standards are met.