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Shallow anterior chamber after ICL implant can have several causes
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SEATTLE — A number of conditions can produce a shallow anterior chamber after implantation of a posterior chamber phakic IOL, and each needs to be treated differently, said Stephen S. Bylsma, MD.
Dr. Bylsma presented case studies during the ASCRS Summer Refractive Congress here last week to differentiate the various conditions that can cause a shallow chamber after implantation of the STAAR Visian ICL.
“They all can look quite similar to each other,” he said. “We have to stop talking about anterior chamber depth as anterior and posterior chamber, because it’s become critical now that we have this partition that is moveable.”
Among the conditions he discussed were pupillary block glaucoma, oversized ICL vault with angle-closure glaucoma, wound leak, retained viscoelastic syndrome and malignant glaucoma. Correct treatment for these conditions requires accurate diagnosis, he said.
Of some concern for ophthalmologists is how to recognize an ICL vault caused by high pressure.
“It is important to be ready with pupillary block and be able to recognize it as opposed to a high vault,” Dr. Bylsma said. “The diagnostic maneuver is to dilate the pupil. If you dilate the pupil, if it is pupillary block, the vault will go down.”