Pigment dispersion with elevated intraocular pressure after AcrySof intraocular lens implantation in the ciliary sulcus

Journal of Cataract and Refractive Surgery
R Wintle, M Austin

Abstract

A 45-year-old white woman had phacoemulsification with intraocular lens (IOL) implantation. The surgery was routine except for a linear tear in the posterior capsule; there was no disruption of the anterior vitreous face. After residual soft lens matter was removed, an AcrySof IOL was placed in the ciliary sulcus. One month postoperatively, the patient presented with an intraocular pressure (IOP) of 30 mm Hg and signs of pigment dispersion with 360 degrees of heavy pigmentation of the trabecular meshwork and iris transillumination defects. Intraocular pressure was controlled with a topical beta-blocker. The optic disc appearance and visual field remained normal, but the uniocular hyperpigmentation of the trabecular meshwork was still present. We hypothesize that the sharp square edge of the AcrySof IOL increases the risk of a chafing effect on the posterior iris pigment and advocate that this IOL be placed in the capsular bag and ideally have 360 degrees of protective overlapping of the anterior capsule over the edge of the optic.

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Citations

Jul 22, 2008·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·D Kook, T Kohnen
Oct 22, 2002·Journal of Cataract and Refractive Surgery·Tasha MicheliMinas T Coroneo
Oct 3, 2003·Journal of Cataract and Refractive Surgery·Rupal H Trivedi, M Edward Wilson
Oct 3, 2001·Journal of Cataract and Refractive Surgery·R J Mackool
Dec 10, 2013·Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie·David MostafaviJohn Danias
Aug 10, 2010·Journal of Cataract and Refractive Surgery·Omar HadidScott Fraser
Dec 9, 2009·Journal of Cataract and Refractive Surgery·M Camille AlmondPhilip P Chen
Jul 28, 2009·Journal of Cataract and Refractive Surgery·David F ChangUNKNOWN ASCRS Cataract Clinical Committee
Feb 4, 2012·Journal of Refractive Surgery·Ioannis G PallikarisGeorge A Kounis
Oct 26, 2005·Journal of Cataract and Refractive Surgery·Takeshi Iwase, Nobushige Tanaka
Aug 18, 2005·Journal of Cataract and Refractive Surgery·Russell M LeBoyerJames J Augsberger
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Oct 22, 2013·Journal of Cataract and Refractive Surgery·Hideo ItagakiTetsuro Oshika
Oct 12, 2004·Journal of Cataract and Refractive Surgery·Shirley H L Chang, Gerald Lim
May 12, 2010·Journal of Cataract and Refractive Surgery·Abhay R VasavadaPanagiotis Theoulakis
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