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Acute haptic-induced pigmentary glaucoma with an AcrySof intraocular lens
Tasha Micheli1, Leanne M Cheung, Shanel Sharma
1Ophthalmic Surgery Centre, University of New South Wales, Sydney, Australia.
Journal of Cataract and Refractive Surgery
|October 22, 2002
Summary
This case report highlights a patient who developed pigmentary glaucoma after an AcrySof intraocular lens (IOL) haptic dislocated into the eye's sulcus. IOL removal and exchange led to an excellent recovery, suggesting sulcus placement may be problematic for this IOL type.
Area of Science:
- Ophthalmology
- Medical Case Reports
Background:
- Cataract surgery involves intraocular lens (IOL) implantation to restore vision.
- AcrySof single-piece IOLs are commonly used for in-the-bag implantation.
- Potential complications of IOLs include dislocation and secondary glaucoma.
Observation:
- A 49-year-old male patient experienced uneventful cataract surgery with in-the-bag AcrySof SA60AT IOL implantation in his right eye.
- Postoperatively, the patient presented with ocular pain, elevated intraocular pressure (48 mm Hg), and signs of pigment dispersion.
- The IOL haptic had dislocated from the capsular bag into the ciliary sulcus, causing 360-degree trabecular meshwork hyperpigmentation and iris pigment epithelial atrophy.
Findings:
- Scanning electron microscopy of the explanted IOL revealed a rough lateral surface and anterolateral edge on the haptic.
- The patient developed acute pigmentary glaucoma secondary to haptic contact with the iris and ciliary body.
- The IOL was successfully removed and exchanged, resulting in an excellent patient recovery.
Implications:
- This case suggests that AcrySof SA60AT single-piece IOLs may not be suitable for sulcus placement due to haptic design.
- Haptic morphology could contribute to pigment dispersion and secondary glaucoma if the IOL dislocates.
- Further investigation into IOL haptic design and sulcus implantation risks is warranted to prevent adverse outcomes.