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Clinical case of phakic intraocular lens rotation

Purpose. To analyze causes of the emerged postoperative rotation of the phakic intraocular lens (PIOL) of the IPCLT V2.0 model, to assess the effectiveness of its elimination and the outcomes. Clinical case. Patient A., 42 years old. Clinical diagnosis: High myopia, chorioretinal form, direct corneal astigmatism in both eyes. The combination of thin cornea with limbal vascularization did not allow to perform for him photorefractive surgery. The implantation of PIOL IPCLT V2.0 model was performed according to the method recommended by the manufacturer. On the first day after the operation, the position of the PIOL was correct in both eyes. Indicators of uncorrected visual acuity significantly increased from initial 0.01–0.02 to 0.4–0.5. The best corrected visual acuity also increased, amounting to 0.7–0.9 for the right/left eye, respectively. 1.5 months after the operation, the patient complained of a decrease and the appearance of instability in visual acuity in both eyes. Biomicroscopic examination revealed the PIOL rotation along the plane from a horizontal to a vertical position. Conclusion. At the stage of preoperative examination, special attention should be paid to the presence of circular symmetry of the zonule of Zinn attachment to the ciliary processes and to the lens capsule. Such indirect clinical signs as prolapse of the iris, asymmetry of the distances «ciliary processes – the edge of the lens» may indicate the presence of individual unfavorable anatomical features of the shape of the eye, which with high probability can lead to displacement or rotation of the PIOL IPCLT V2.0 model. Key words: myopia, phakic intraocular lens (PIOL), PIOL IPCLT V2.0 model.