Anterior Uveitis with Posterior Synechia and Iris Atrophy Following Implantation of a Phakic Intraocular Lens

PURPOSE: To describe a case with acute postoperative uveitis, posterior synechia and iris atrophy following iris-claw phakic intraocular lens (pIOL) implantation. METHODS: A case report. RESULTS: A 26-year-old man with high myopia had implantation of a −14.0 diopter, foldable, iris-claw Artiflex (model 401) anterior chamber pIOL (Ophtec B.V.) in both eyes. On the third postoperative day, the patient had significant postoperative inflammation in the left eye and received topical steroids and mydriatic eye drops. On the fifth postoperative day, the right eye had a round pupil and centered pIOL, but the left eye had an atrophic iris and dilated pupil with significant posterior synechias over the inferior half of the pupil. Despite intensive topical steroid application, the synechias remained one year after surgery. CONCLUSION: Severe uveitis with posterior synechia can occur after iris-claw pIOL implantation. We hypothesized that excessive iris tissue enclavation in the pIOLs haptics and large iridotomies may be an associated factor.