A Case of a Low Vault after Posterior Chamber Acrylic Phakic Intraocular Lens Implantation.

When implanting a posterior chamber phakic intraocular lens (pIOL), it is crucial to maintain a safe distance. The patient was a 29-year-old man with high-degree bilateral myopia. In February 2021, posterior chamber acrylic pIOLs (Eyecryl Phakic TORIC; Biotech Vision Care, Gujarat, India) were implanted in both his eyes. After the surgery, the right eye vault was 6 μm, and the left eye vault was 350 μm. Moreover, the internal anterior chamber depth values were 2,270 and 2,220 μm for the right and left eyes, respectively. In our case, we found a fairly high crystalline lens rise (CLR) in both eyes, but it was greater in the right eye. The CLR value was +455 in the right eye and +350 in the left eye. In our patient, anterior segment anatomical parameters were higher in the right eye than in the left eye, and a greater pIOL length was calculated for the right eye, but the vault was very low. In our opinion, this was associated with the high CLR in the right eye. If an even larger pIOL had been implanted, there would have been a greater narrowing of the anterior chamber angle. This case would be contraindicated if those parameters were considered in selecting the indications and determination of the pIOL length.