Cat Eyes – Iris Capture as Unusual Complication after Implantation of the Phakic Posterior Chamber Intraocular Lens

Patient Introduction

A 24-year-old student presented to the refractive service of our tertiary care medical center for treatment of myopic astigmatism. She expressed an interest in surgical correction with implantable phakic intraocular lenses to correct her refractive error and decrease her need for visual correction. The patient had been prescribed spectacles since age 6 but had refused to wear them up until recent years, when her visual difficulties started to increase.

Given her active lifestyle, she reported that the use of spectacles was particularly unpleasant. The patient had already gathered information about options of laser vision correction (LVC) procedures but explicitly did not want to undergo LVC due to concerns about permanent changes to the cornea. Instead, she preferred the option of phakic intraocular lenses (pIOLs) due to the advantage of reversibility. Additionally, the patient reported no concurrent systemic conditions, regular use of prescription medications, or allergies. Ocular history was unremarkable, including no previous eye surgeries.

Best-corrected distance visual acuity (BCDVA) was 0.1 logMAR (OD) and 0 logMAR (OS). The best-corrected tests using Bagolini lenses (distance and near) and Langʼs test showed no abnormalities. The objective and subjective refraction (at 5 meters and with a back vertex distance of 15 mm) performed in undilated and cycloplegic states revealed closely matching values ([Table 1]). Biometry and tomography were performed with the IOLMaster 700 (IOLM700, Carl, Zeiss Meditec AG, Jena, Germany) and Pentacam (Oculus AG, Wetzlar, Germany), respectively. Scheimpflug-derived tomography maps of corneal curvature, pachymetry, and elevation are displayed in [Fig. 1]. During the clinical examination, both eyes showed normal intraocular pressure (18 mmHg/19 mmHg) and a healthy endothelial cell count (2653 cells/mm²/2549 cells/mm²). Retinal nerve fiber analysis and macular optical coherence tomography (OCT) (Spectralis, Heidelberg Engineering, Heidelberg, Germany) showed no significant findings.

Publication History

Received: 31 October 2023

Accepted: 20 November 2024

Accepted Manuscript online:
21 November 2024

Article published online:
27 January 2025

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