Abstract: Objective To observe the causes leading to reoperation after the implantation of phakic posterior chamber implantable collamer lens (PPC-ICL), also known as implantable collamer lens(ICL), and to explore the potential treatment options and preventive measures. Design Retrospective case series. Participants 8 patients (11 eyes) required reoperation due to a variety of reasons, whom out of 342 patients (669 eyes) who underwent PPC-ICL implantation at Jinan Mingshui Eye Hospital from July 2019 to April 2022. Methods The medical records were reviewed, and the examining general conditions and ocular data including refractive error, anterior chamber depth, corneal diameter, ciliary sulcus diameter, ICL data, vault hight, and reasons for reoperation were recorded. The time, management, and prognosis of these reoperations were also assessed. The reasons for reoperation, potential treatment options and preventive measures were discussed. Main Outcome Measures The reasons for reoperation, the time of reoperation, treatment methods, and prognosis. Results In the 11 reoperated eyes, five were implanted of regular ICLs and six were implanted of Toric ICLs (TICLs), which were all implanted horizontally. The reasons for the reoperation were the ICL rotation and the abnormal vault hight. Three TICLs experienced rotation and had to be repositioned. The mean vault hight measured before the reoperation was (1.28±0.14) mm, which subsequently decreased to (0.73±0.12) mm post-reoperation (P<0.05). In one particular case, a lower vault was executed and a larger size ICL was chosen in the reoperation. However, there was not a significant change in the vault after the operation. Conclusion The common reasons prompting reoperation after PPC-ICL implantation includes abnormal postoperative vault height and ICL rotation, for which alignment or replacement surgery proves effective. Preoperative accurate examination and measurement, combining multiple examination results, improving the predictability of vault height, selecting the appropriate ICL size, and avoiding accidental injury may be the possible countermeasures to prevent the reoperation. (Ophthalmol CHN, 2023, 32: 245-250)

Key words: phakic posterior chamber implantable collamer lens, vault height, rotation, reoperation