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Article History

Received: 22 January 2026

Accepted: 5 May 2026

First Online: 2 June 2026

Declarations

:

: According to the policies of our institution and national regulations, formal ethics committee approval was not required for this single-patient case report, as all investigations and treatments were part of routine clinical care and the patient was managed according to standard practice.

: was obtained in writing from the patient to use the relevant details for this case report. A copy of the consent form is available for review by the Editor of this journal.

: What Was Known - Corneal Decompensation is a recognized complication of anterior chamber phakic intraocular lens implantation. To the Authors’ knowledge, there has only been one other case report of endothelial decompensation requiring an AC pIOL explantation and a subsequent DMEK more than a decade after AC pIOL implantation. What This Paper Adds - This paper reports the development of bullous keratopathy requiring a keratoplasty as a complication of anterior chamber phakic intraocular lens implantation, occurring more than a decade after the original refractive correction procedure, which is a longer onset than what has been reported in other studies and case reports. The long timeframe within which this complication can occur emphasizes the need for careful patient counselling and regular lifelong monitoring with annual specular microscopy post-operatively. This report also provides insight into the management of severe bullous keratopathy in a patient with iris-fixated anterior chamber phakic intraocular lenses.

: The authors declare no competing interests.