A 35-year-old man, a unilateral high myope with corneal scarring, presented for evaluation. He had a stromal scar that started temporally, traversed along the pupillary zone partially and extended across the horizontal diameter of the cornea. The Descemet's membrane appeared intact even though the scar was extending into deep stroma towards the nasal end, as seen in the optical coherence tomography image. The patient had an uncorrected distance visual acuity (UDVA) of 4/60 OD, which improved with a refraction of −9.0 DS/−1.50 DC at 15 to 6/18p and 6/6p OS. He underwent an uneventful toric implantable collamer lens (ICL) implantation of −15.0 D/−2.0 D at 102 after preoperative yttrium–aluminium–garnet (YAG) laser iridotomy in the right eye. The postoperative UDVA and corrected distance visual acuity for the right eye were 6/12 and 6/9p (with a refraction of +0.50 D/−0.50 D at 85), respectively. The corneal scar and topography were stable. This case reports an expanded indication for toric ICL in cases with corneal scar/opacity but good spectacle corrected visual acuity.
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