Direct Neodymium:YAG Laser Over the Occluded Phakic Implantable Collamer Lens Port to Manage Pupillary Block

Purpose: To present the first case of a pupillary block that was successfully managed with neodymium:YAG (Nd:YAG) laser to eliminate the obstruction of the central port in patients with Implantable Collamer Lens (ICL) implantation. Methods: Case report and literature review. Results: A V4c ICL (STAAR Surgical) was implanted in a 25-year-old woman, and the intraocular pressure was 47 mm Hg 2 months later. Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) indicated that this patient underwent pupillary block, and a membranous structure was found in the ICL hole. Nd:YAG laser was uneventfully applied to the membranous structure to eliminate the pupillary block. Conclusions: This is the first case of direct Nd:YAG over the occluded phakic IOL port to manage pupillary occlusion, which broadens the experience of ophthalmologists. Nd:YAG laser treatment is one of the effective options for pupillary block in patients with ICL implantation.