First Author: Y.Hong CHINA
Co Author(s): Y. Hao
Purpose:
To study the possible mechanism and treatment of pigment dispersion glaucoma caused by single-piece acrylic (SPA) Intraocular lens (IOL) ciliary sulcus fixation in Asian eyes
Setting:
University anterior segment surgery practice
Methods:
Cases referred for pigment dispersion glaucoma caused by sulcus placement of SPA IOL from 2005 to 2011 were included. General imformations, IOL types, interval of initial surgery and pigment dispersion glaucoma, Intraocular pressure (IOP), examination findings, antiglaucoma medicine and our treatment were recorded.
Results:
There are 5 eyes of 4 patients included in this study. All were implanted single-piece acrylic IOL during cataract surgery. The IOP increased progressively from 1 to 5 months after cataract surgery, and the highest IOP reached to 50 mmHg. Antiglaucoma eye drops were not effective enough, all patients need oral antiglaucoma medicine. Slit lamp examination showed all IOLs were vertical placed and the superior loop of IOL was not in the capsular bag. The loop chafed with the posterior pigment epithelium of iris, dense pigmentation deposited at the edge of the IOL loop and anterior chamber angle. IOL reposition in the capsular bag was performed in 2 eyes of 2 patients. IOL reposition combinedd trabeculectomy were performed in 2 eyes of 1 patient since progressive visual defect had happened. The capsular bag of the rest patient was closed tightly and hard to reopen, so we exchanged the single-piece acrylic IOL with a 3-pieces IOL of cililary sulcus fixation. All patients were followed 1-6 years. The IOLs remained stable. All IOP were controlled during the followups.
Conclusions:
Our study demonstrated it was not suitable for single piece acrylic IOL ciliary sulcus fixation. The chafing effect of loops and posterior iris pigment epithelium could induce pigment dispersion even pigmentary glaucoma in Asian eyes. FINANCIAL DISCLOSURE?: No
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