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Middle East Afr J Ophthalmol. 2019 Sep 30;26(3):181-183. doi: 10.4103/meajo.MEAJO_197_18. eCollection 2019 Jul-Sep.

Unilateral Malignant Glaucoma Postbilateral Implantable Collamer Lens: Effect of Miotics.

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Department of Cornea and Refractive Surgery, Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon.
Department of Ophthalmology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.


An implantable collamer lens® (ICL) V4c model (STAAR Surgical, Monrovia, CA, USA) was placed in the eye of a 31-year-old male patient with high myopia followed by the development of malignant glaucoma. After failing medical treatment for 5 days, a noncomplicated pars plana vitrectomy and anterior hyaloidectomy succeeded in breaking the aqueous misdirection. Sixteen months later, intraoperative miotics were purposefully withheld from the ICL surgery in the fellow eye and malignant glaucoma did not develop. Even though the patient's visual acuity postoperatively was 20/20, OU, a single small atrophic iris patch in the affected eye resulted in slightly more halos and glare in mesopic conditions as compared to the fellow eye. Earlier surgical intervention may have prevented iris ischemia and iridocorneal touch with its subsequent iris atrophy and resulted in an even more favorable visual outcome. Withholding intraoperative miotics during ICL surgery appeared to be beneficial in this case.


Glaucoma; implantable collamer lens; malignant glaucoma

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