Retinal detachment after ICL surgery treated with foldable capsule buckle: a case report

Background High myopia represents an established risk factor for rhegmatogenous retinal detachment (RRD). For patients with an implanted ICL, conventional retinal reattachment surgery may alter anterior segment anatomy and jeopardize ICL stability.The foldable capsular buckle (FCB) provides a reversible surgical option, yet documented experience of FCB for RRD in ICL-implanted eyes remains limited. We report this case to share our management strategy for this challenging clinical scenario. Case presentation A 27-year-old woman presented with 4 days of visual obscuration in the left eye. She underwent bilateral ICL implantation for high myopia two years previously. Fundus examination of the left eye demonstrated a horseshoe retinal break with associated retinal detachment. Preoperative anterior segment optical coherence tomography (AS-OCT) showed ICL vaults of 0.59 mm (right eye) and 0.44 mm (left eye). She underwent FCB implantation, subretinal fluid drainage, cryotherapy and endolaser photocoagulation. The FCB was removed one month after the primary surgery. At the 3-month follow-up, the retina remained attached. Postoperative AS-OCT revealed stable ICL vaults of 0.61 mm in the right eye and 0.51 mm in the left eye. Conclusions For young patients who developed RRD after previous ICL surgery for high myopia, FCB implantation combined with laser photocoagulation or cryopexy can be considered. This technique is reversible, boasts favorable safety and efficacy profiles, and causes no alterations to the anterior segment structures.