Surgical management of acute angle-closure glaucoma after toric implantable contact lens implantation.

A case of pupillary block after implantation of an implantable contact lens (ICL) is reported, and surgical management and prevention are discussed. In a myopic patient, the best corrected visual acuity in the right eye was 20/50 with -15.50 -3.00 x 175. After uneventful implantation of an ICL, painful acute glaucoma developed with an intraocular pressure beyond measurable values. Apparent anterior vaulting of the ICL suggested a sizing problem. In a situation of a mid-wide dilated pupil, immediate explantation of the ICL was performed. Then, using a preoperative iris photography as guidance, an anterior chamber iris-claw toric phakic intraocular lens was implanted. On postoperative examination, the anterior chamber was deep, the angle open, the natural lens clear, and uncorrected visual acuity was 20/40.