Late-onset pigment dispersion glaucoma after phakic implantable collamer lens implantation: A case report

Implantable collamer lens (ICL) implantation is a common refractive surgery for the treatment of high myopia, but its late-onset postoperative complications are rarely reported.

A 27-year-old patient presented with progressive vision loss and a visual field defect in the left eye, which had persisted for 1 year following ICL implantation 7 years prior. He was initially misdiagnosed with angle-closure glaucoma at a local hospital.

Upon detailed gonioscopy examination, we observed that the patient's anterior chamber angle remained open, albeit with significant pigmentation present. Therefore, the diagnosis of pigment dispersion glaucoma should be revised.

To effectively manage intraocular pressure (IOP) and prevent progressive optic nerve damage in the left eye, we performed Kahook dual blade ab-interno trabeculectomy.

The IOP of left eye ranged from 10 to 16 mm Hg 1 month after operation while 14 mm Hg at 1 year postoperatively without any antiglaucoma medication, in contrast to preoperative IOP levels that ranged from 25 to 29 mm Hg while 2 different antiglaucoma medications applied. Additionally, both visual acuity and visual field remained unchanged compared to preoperative.

The application of gonioscopy to accurately assess the angle status is crucial in the diagnosis and management of glaucoma. Furthermore, it is imperative to give due attention to potential late onset postoperative complications following ICL implantation.