Secondary glaucoma after anterior chamber intraocular lens implantation
Objective: To investigate the intraocular pressure level, the change of anterior chamber angle and the occurrence of secondary glaucoma after anterior chamber intraocular lens (AC-IOL) implantation.
Methods: Sixty-two AC-IOL implanted eyes were followed up postoperatively for 3 months to 7 years (mean 31 months). The examination of anterior chamber angle was emphasized. The type of cataract mainly included senile and traumatic. The operation performed were lensectomy with anterior vitrectomy or extracapsular cataract extraction (ECCE) combined with primary or secondary AC-IOL implantation.
Results: The incidence of postoperative peripheral anterior synechia (PAS) of iris was 87.1% and that of the secondary glaucoma (mainly the angle-closure) was 11.3%. The incidence of the glaucoma after ECCE with primary or secondary implantation was 17.4%, while that after ECCE combined with anterior vitrectomy was 0%.
Conclusions: The main causes of the secondary glaucoma are possibly the rupture of posterior capsule and vitreous loss during the surgery leading to postoperative severe uveitis and pupillary block. To prevent its occurrence, it is important to combine ECCE with anterior vitrectomy.