Reversible dilation of pupil with 0.125% pilocarpine in a patient with Urrets-Zavalia syndrome after implantable collamer lens implantation

Phakic intraocular lenses (pIOLs) are widely used as an alternative to commonly practiced refractive surgeries, including laser-assisted subepithelial keratomileusis, and laser in situ keratomileusis. Multiple options for their implantation are available, but posterior chamber pIOLs are the most used ones and are implanted in front of the crystalline lens. Their use is mainly indicated in patients with very high myopia of >−10D as well in cases of thin corneas and increased corneal curvature. The safety and efficacy of the implantable collamer lens (ICL) have been well reported. Herein, we report a unique case of a variant of unilateral Urrets-Zavalia syndrome having a reversible dilation of the pupil with 0.125% pilocarpine with normal post-op intraocular pressure (IOP) after ICL implantation.