Icl Implantation After Clear Lens Exchange：A Case Report

Reports on the corrective effect and safety of Implantable Collamer Lens (ICL) implantation in a patient after clear lens exchange, emphasizing the precautions for selecting the size of ICL in patients with IOL.

Both Implantable Collamer Lens (ICL) implantation and clear lens extraction (CLE) are currently common and highly safe intraocular refractive procedures in clinical practice. Previous literature has documented that residual refractive errors can be effectively and safely corrected by secondary ICL implantation in the ciliary sulcus following intraocular lens (IOL) placement.

A high myopia patient underwent bilateral clear lens exchange for refractive correction, achieving good postoperative visual outcomes. However, nine years later, the left eye developed myopic regression. To address the new refractive error, an additional implantable collamer lens (ICL) was implanted in the left eye, leaving the existing intraocular lens (IOL) in place. Preoperative ultrasound biomicroscopy (UBM) revealed a decrease in the sulcus-to-sulcus (STS) measurement compared to data obtained nine years earlier. Based on the patient's historical UBM parameters, an ICL of appropriate size was selected. Intraoperatively, the ICL was found to be oversized and was therefore rotated to a vertical orientation. Postoperatively, the patient achieved satisfactory visual recovery. This case demonstrates the importance of considering long-term changes in ocular dimensions when planning secondary ICL implantation.

ICL implantation demonstrated effective correction of secondary refractive error following prior IOL surgery. However, appropriate ICL sizing requires consideration of potential UBM measurement alterations resulting from capsular bag contraction after IOL implantation, thereby minimizing the risk of postoperative complications associated with ICL alignment or replacement.