Implantation of an implantable collamer lens and iris cerclage for the treatment of Urrets-Zavalia syndrome

A 27-year-old woman with bilateral high myopia had anterior chamber iris-claw phakic intraocular lens implantation in her left eye under local anesthesia and with no intraoperative complications. The preoperative slit-lamp examination was normal, and she had no relevant past medical history. On the second postoperative day, patient developed fixed, dilated mydriasis, and one month later, an IOL subluxation was noted on examination. She had no history of intraocular hypertension and no mydriatic drops were used. She was ultimately diagnosed with Urrets-Zavalia syndrome. We removed the IOL and observed the patient for six months after fitting her with a colored contact lens. During this period of time, she complained of glare and photophobia and developed contact lens intolerance. To bring more comfort to the patient, we implanted a posterior chamber Implantable Collamer Lens (ICL) and performed iris cerclage in the left eye with good aesthetic and refractive outcome. Posterior chamber ICL implantation with iris cerclage proved to be a simple and effective approach in the management of this situation.