Introduction: This case presented an unusual diffuse corneal edema after V4c implantable collamer lens (ICL) implantation. Patient and Clinical Findings: A 29-year-old woman underwent ICL implantation in both eyes on the same day. The 1-day postoperative routine follow-up visits revealed diffuse foggy corneal edema, keratic precipitates, a significant number of cells, and whitish anterior chamber pus with hazy vision in the right eye. Fundus examination was normal. Her bacterial, viral, fungal, and immune-related markers of anterior chamber fluid metagenomic testing all yielded negative results. Diagnosis, Intervention, and Outcomes: Toxic anterior segment syndrome (TASS) was suspected, and intensive topical steroids were administered, along with anterior chamber fluid release. After 4 weeks of topical steroid treatment, the patient achieved 20/20 uncorrected distance visual acuity and cornea was clear in the right eye. Conclusions: Although TASS is rare after ICL implantation, it is still at risk of occurring. This case report suggested that it is crucial for ophthalmologists to identify rare complications including diffuse corneal edema after ICL implantation and conduct close monitoring and timely intervention treatment.
Zhang et al. (Thu,) studied this question.