A novel ophthalmic application of the Nd:YAG laser: reopening the obstructed central port of the Visian Implantable Collamer Lens in the management of acute angle-closure glaucoma

This case report describes the successful reopening with an Nd:YAG laser of a central port obstruction that developed after EVO Visian Implantable Collamer Lens (ICL) implantation.

A 23-year-old female patient underwent EVO Visian ICL implantation in the left eye. A few hours after surgery, the patient developed severe ocular pain and a rise in intraocular pressure (IOP). Examination revealed acute angle-closure glaucoma, shallowing of the anterior chamber and fibrin deposition in the central port of the ICL.

The fibrin material obstructing the central port was cleared by Nd:YAG laser fibrinolysis and aqueous humour flow was restored. After the procedure, intraocular pressure fell to normal levels within a short time and no additional glaucoma treatment was required. Follow-up showed marked improvement in anterior chamber depth and angle values, and the patient achieved full visual acuity.

This case demonstrates that the Nd:YAG laser is a rapid, effective and safe treatment option for the rare central port obstructions that may occur after EVO Visian ICL implantation.