DSAEK for implantable collamer lens dislocation and corneal decompensation 6 years after implantation

A 39-year-old woman with a history of high myopia underwent uneventful implantation of phakic posterior chamber implantable collamer lenses (ICLs) 6 years earlier in both eyes with a visual acuity of 20/20 bilaterally. The patient presented as an emergency with sudden decreased vision in her right eye after blunt trauma. Slit-lamp examination showed a partially dislocated ICL in the anterior chamber, associated with ocular hypertension. It was decided to treat her with topical ocular hypotensive agents and surgical repositioning of the ICL. There was a progressive loss of endothelial cells and decreased visual acuity. Descemet stripping automated endothelial keratoplasty was needed to correct the endothelial failure. This case presents a potential complication of the ICL several years after implantation, and should be considered in these types of procedures.