Non-viscoelastic Repositioning of Dislocated Toric and Non-toric Implantable Collamer Lens After Blunt Trauma

PURPOSE: To describe a new minimally invasive technique for the treatment of uncomplicated Visian Implantable Collamer Lens (ICL) (STAAR Surgical) luxation in the anterior chamber in two cases. METHODS: A single or double 1-mm watertight corneal paracentesis was made with no viscoelastic or irrigation/aspiration. The ICL was then repositioned and pupil contraction was induced with intracameral injection of acetylcholine. Hydration of the corneal paracentesis and injection of intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL) were done. RESULTS: Both cases had a normal follow-up with no significant complication. First day postoperative vault evaluated with anterior segment optical coherence tomography was 480 µm for case 1 and 1,010 µm for case 2. At the last follow-up visit, the ICL was centered in both cases with a subjective vault of 2 in case 1 and a vault of 1 in case 2. No cataract formation was described. CONCLUSIONS: This minimally invasive technique can be a fast and effective method to treat ICL decentration. The corneal paracentesis should be watertight and injection of balanced salt solution in the anterior chamber should be done to increase its depth. In addition, the movement should be fast without touching the iris or the crystalline lens, only the ICL. [ Journal of Refractive Surgery Case Reports. 2022;2(1):e18–e21.]