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Late pigmented-membrane formation on silicone intraocular lenses after phacoemulsification with or without
Y Friedrich1, Y Raniel, E Lubovsky
1Annette & Aron Rozin Department of Ophthalmology, Bnai-Zion Medical Center, Faculty of Medicine, Haifa, Israel.
Purpose:
To determine the incidence of late inflammatory membrane formation with pigment precipitates on foldable silicone or poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) after phacoemulsification with or without simultaneous trabeculectomy and to identify probable causative factors.
Setting:
Eye Department, Bnai-Zion Medical Center, and the Faculty of Medicine, the Technion, Haifa, Israel.
Methods:
In this retrospective study, 155 eyes (140 patients) were divided into 4 groups by the surgery performed: Group 1, phacoemulsification combined with trabeculectomy and foldable silicone IOL implantation (12 eyes); Group 2, phacoemulsification combined with trabeculectomy and PMMA IOL implantation (15 eyes); Group 3, phacoemulsification alone with foldable silicone IOL implantation (66 eyes); Group 4, phacoemulsification alone with PMMA IOL implantation (62 eyes). Preoperative, intraoperative, and postoperative data were compared.
Results:
Late inflammatory membranes were found on the anterior surface of 33% of the IOLs in Group 1, 3% in Group 3, and none in Groups 2 and 4. Membranes developed 3 to 4 months after surgery, were resistant to topical corticosteroid treatment and required repeated neodymium:YAG laser treatments. No correlation with preoperative, intraoperative, or postoperative factors was found.
Conclusion:
Foldable silicone IOLs may induce late postoperative inflammatory membranes with pigment precipitates, especially after combined phacoemulsification and trabeculectomy.