Delayed uveitis after implantable Collamer lens Implantation caused by COVID-19 infection: a case report

This report presents a case of uveitis secondary to ankylosing spondylitis (AS) with abnormal exudative deposits and pigment adhesion on the surface of an implantable Collamer lens (ICL) in a highly myopic eye following coronavirus disease 2019 (COVID-19) infection. The etiology and treatment were analyzed. A 22-year-old male presented with decreased visual acuity in the right eye, having undergone bilateral ICL implantation for high myopia 22 months prior. During the COVID-19 pandemic, he developed ocular exudation, pigment deposition, and vision deterioration, with a confirmed diagnosis of AS. Therapeutic interventions included anti-inflammatory, antiviral, and corticosteroid therapies. Postoperative uveitis secondary to AS following ICL implantation represents a rare complication. COVID-19 infection and concurrent systemic autoimmune disorders were identified as risk factors for secondary iridocyclitis. Immunological testing confirmed AS diagnosis. Treatment with sodium hyaluronate eye drops, ganciclovir ophthalmic gel, and systemic corticosteroids improved symptoms; however, persistent punctate exudates and pigment deposits on the ICL surface exhibited limited resolution. For patients with systemic autoimmune diseases or virus-induced uveitis undergoing ICL implantation, preoperative immunological screening should be actively performed to minimize postoperative complications. Early comprehensive therapy is critical to prevent progressive vision loss and rare transparency alterations of the ICL surface caused by pigment-laden exudates.