Dr.Nadisha Puri,Dr.Suhas Haldipurkar,Dr.Vijay Shetty,Dr.ABHISHEK HOSHING
Implantable collamer lens (ICL) are used in high myopes, who cannot be corrected with laser refractive surgery. Measuring horizontal white-to-white (WTW) diameter, manually or optically, is the most widely practiced technique for sizing the ICL. The indications for ICL exchange include improper sizing and post-op refractive surprise. Undersizing causes a central lenticular touch leading to an Anterior Subcapsular Cataract. Oversizing causes secondary angle closure glaucoma. Although new generation ICLs prevent pupillary block ; non pupillary block angle closure remains a complication. In this video we discuss the technique of ICL exchange through a 2.8mm incision. The indication was high vault >2.5 times the corneal thickness which was causing shallow anterior chamber. Care was taken to avoid mechanical damage to the endothelium and anterior lens capsule by using appropriate viscoelastic agents. Oversized ICL was removed without cutting it. 0.5mm smaller ICL was inserted in its place.