Phakic intraocular lens exchange due to severe uveitis/inflammation: case report

Introduction: Phakic intraocular lenses (IOLs) provide excellent visual and refractive outcomes with a high safety profile. This report illustrates a case of a rare episode of severe anterior segment inflammation after iris-claw foldable lens implantation, which required surgical reintervention. Patient and Clinical Findings: A 22-year-old woman was submitted to Artiflex implantation for the correction of myopia. Three months postoperatively, a severe anterior segment inflammation developed with pigment deposition, pupillary membrane formation, and decreased visual acuity in the left eye. Diagnosis, Intervention, and Outcomes: Given the nonresponse to medical treatment (topical and systemic corticosteroid for 3 months), surgical explantation of the IOL with peeling of a pigmentary membrane over the crystalline lens was performed. During a 24-month follow-up period, the patient was monitored to exclude the development of cataract or glaucoma. Afterward, an implantable collamer lens was implanted with an uneventful intraoperative and postoperative period. During the long-term follow-up, no further pigment dispersion, uveitis, or cataract was described. Conclusions: Persistent anterior uveitis with pigmentary membrane formation after iris-claw lens implantation is a rare complication. IOL explantation needs to be considered to prevent further sequelae after severe uveitis when the situation is unresponsive to medical treatment.