Implantation of single-piece hydrophobic acrylic intraocular lens in the ciliary sulcus

Abstract

Objective: To report the association of sulcus-fixated, single-piece hydrophobic acrylic intraocular lenses (HAIOL) with pigment-dispersion syndrome (PDS) and pigmentary glaucoma (PG). Methods: This is a noncomparative consecutive case series of 20 eyes that underwent sulcus implantation of a single-piece HAIOL after posterior-capsule rupture (PCR) during phacoemulsification. The following data were analyzed: postoperative best-corrected visual acuity (BCVA); manifest refraction; frequency of IOL decentration, dislocation, and repositioning; intraocular pressures; gonioscopic findings; and postoperative complications. Results: The postoperative BCVA was 20/40 or better in all eyes. The mean postoperative sphere was –0.05 ± 0.7 diopters (range, +1.25 to –2.00) and the mean postoperative cylinder was –1.2 ± 0.8 diopters (range, 0 to –2.50). None of the HAIOLs became decentered, dislocated, or required repositioning. Seven eyes (35%) developed PDS while 3 eyes (15%) developed PG that required IOP-lowering medications or filtering surgery. The average follow-up period was 17.2 ± 9.4 months (range, 6 to 36). Conclusion: Implantation of single-piece HAIOLs in the ciliary sulcus is associated with PDS and PG. Alternative methods of aphakic correction should be considered in cases of PCR.

Keywords

• ciliary sulcus
• hydrophobic acrylic intraocular lenses
• pigment-dispersion syndrome
• pigmentary glaucoma
• aphakic correction