Late-onset secondary pigmentary glaucoma following foldable intraocular lenses implantation in the ciliary sulcus: a long-term follow-up study

Shirley HL Chang, Wei-Chi Wu, Shiu-Chen Wu

BACKGROUND: To review the long-term outcomes of eyes with secondary pigmentary glaucoma associated with the implantation of foldable intraocular lenses (IOL) in the ciliary sulcus. METHODS: The study retrospectively reviewed a series of cases who developed secondary pigmentary glaucoma after cataract operations. Data were collected from cases that were referred between 2002 and 2011. RESULTS: Ten eyes of 10 patients who developed secondary pigmentary glaucoma after foldable IOLs implantation in the sulcus were included in this study.Intraocular pressure (IOP) elevation was present in 2 eyes (20%) within the first 2 weeks following the initial cataract operation. The onset of glaucoma was delayed in the other 8 eyes (80%); the average onset time in these eyes was 21.9 +/- 17.1 months after the initial cataract operation. Six eyes (60%) received surgical treatment because of large fluctuations and poor control of IOPs. Only 3 eyes (30%) achieved final visual acuities better than 20/40. CONCLUSION: Secondary pigmentary glaucoma accompanying the implantation of a foldable IOL in the ciliary sulcus may present as acute IOP elevation during the early postoperative period or, more commonly, late onset of IOP elevation accompanied by advanced glaucomatous optic nerve damage. Despite treatment, the visual prognosis for these patients can be poor. Placing a foldable IOL in the ciliary sulcus could pose a threat to the vision of the patients and long-term follow-up of IOP in these patients is necessary.