Dislocation of Implantable Collamer Phakic Lens after Blunt Trauma: A Case Report

Background: Implantable Collamer Lens (ICL) surgery is a beneficial option for correcting high myopia due to its stable long-term outcomes and improved night vision with a wider optical zone. The reversible procedure is particularly useful for high myopia correction. Traumatic displacement of ICL is rare but carries the potential to develop vision-threatening complication. Timely intervention with thoroughly consideration of surgical planning remains challenging. We present a rare case of traumatic dislocation and pupillary capture of the ICL after blunt trauma, in which the patient underwent surgical intervention of ICL repositioning. Case presentation A 44-year-old man presented with a loss of vision in his left eye, accompanied by photophobia and pain, after receiving blunt ocular trauma from a fist one hour ago. This patient had undergone bilateral ICL implantation for high myopia four years prior to presentation. On examination, one footplate of the ICL was entrapped in the pupillary, located on the nasal side of the iris. The patient showed 4+ red blood cells and Grade I hyphema in the anterior chamber of his left eye, along with moderate vitreous hemorrhage and slight angle recession at the 9 o'clock position. The dislocation and pupillary capture of the ICL were surgically corrected to a horizontal position under topical anesthesia one week after the injury, resulting in a stable location in his left eye with stable postoperative vault. Conclusion: Traumatic ICL dislocation is rare but poses the risk of long-term complications. Prompt intervention can lessen the chances of complications in difficult cases. Thorough examination is vital to quickly identify and diagnose the dislocation, which may mitigate potential vision-threatening complications.