Pseudophacomorphic Glaucoma Along with Pupillary Block after VisianTM Implantable Collamer Lens Implantation for High Myopia

Purpose: To report a case of bilateral glaucoma related to pseudophacomorphic mechanism in one eye and pupillary block in the other eye after Visian Implantable Collamer Lens (ICL; STAAR Surgical) insertion. Methods: A 44-year-old female with high myopia underwent bilateral ICL implantation of MICL12.6 after sulcus diameter measurements were performed by Pentacam. Results: Pseudophacomorphic glaucoma-related angle closure occurred due to lens oversizing in the right eye. The mechanism was relieved via ICL explantation. In the left eye, pupillary block developed in a subacute manner after closure of the Peripheral Iridotomy (PI). The attack was ameliorated by reestablishing patency of the iridotomy. Conclusions: ICL-related glaucomatous attacks may result from improper sizing as well as from placement of a single PI. Identification of the proper mechanism is vital as treatments differ significantly. In pseudo phacomorphic glaucoma, explantation is needed. In pupillary block glaucoma, treatment involves establishment of a patent PI.