Lacquer cracks developing after phakic intraocular lens implantation

J Refract Surg. 2014 Sep;30(9):646-8. doi: 10.3928/1081597X-20140728-01.


Purpose: To describe a case of lacquer cracks developing after phakic intraocular lens implantation.

Methods: Case report.

Results: A 46-year-old woman diagnosed as having extreme myopia and corrected distance visual acuity of 20/40 presented with decreased vision and a central scotoma less than 24 hours following phakic intraocular lens implantation. Dilated examination revealed the presence of a macular hemorrhage and possible lacquer crack formation. Documented preoperative imaging showed an absence of lacquer cracks in the eye that was operated on. The patient was treated with intravitreal bevacizumab. At 4 weeks postoperatively, imaging confirmed an almost complete resolution of the hemorrhagic pigment epithelial detachment with evidence of lacquer cracks. Uncorrected visual acuity was 20/50 and the patient was asymptomatic.

Conclusions: This is the first reported case of macular crack formation immediately following phakic intraocular lens implantation. Possible contributing factors are discussed.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Female
  • Humans
  • Intravitreal Injections
  • Lens Implantation, Intraocular / adverse effects*
  • Middle Aged
  • Myopia / surgery
  • Phakic Intraocular Lenses*
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy
  • Retinal Diseases / etiology*
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / drug therapy
  • Retinal Hemorrhage / etiology
  • Scotoma / diagnosis
  • Scotoma / drug therapy
  • Scotoma / etiology
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab