Intraocular Lens-Associated Uveitis-Glaucoma-Hyphema Syndrome

Area of Science:

• Ophthalmology
• Medical device complications
• Intraocular lens technology

Background:

• Uveitis-glaucoma-hyphema (UGH) syndrome is a known complication associated with intraocular lenses (IOLs).
• Understanding the characteristics of contemporary UGH syndrome is crucial for effective management and improved patient outcomes.

Purpose of the Study:

• To characterize the clinical presentation, timing of onset, management strategies, and outcomes of modern intraocular lens (IOL)-associated uveitis-glaucoma-hyphema (UGH) syndrome.
• To identify factors associated with early-onset versus late-onset UGH syndrome.

Main Methods:

• Retrospective cohort study of 232 eyes diagnosed with UGH syndrome between October 2015 and December 2025.
• Medical records were reviewed for demographic data, IOL characteristics, clinical findings, and outcomes.
• Eyes were stratified into early-onset (≤1 year), intermediate-onset (1-10 years), and late-onset (>10 years) based on time from surgery to diagnosis.

Main Results:

• Posterior chamber IOLs, particularly those in the sulcus, were most commonly implicated (92.2%).
• The median time from surgery to diagnosis was 4.8 years, with common findings including IOL-tissue contact and pigment dispersion.
• Recurrent disease occurred in 46.2% of eyes, and 59.3% experienced persistent ocular hypertension despite surgical intervention in 77.2% of cases.

Conclusions:

• Contemporary UGH syndrome predominantly involves posterior chamber IOLs and often presents years post-surgery.
• Late-onset UGH syndrome is associated with pseudophacodonesis, Soemmering ring formation, and recurrent episodes.
• Persistent ocular hypertension remains a significant challenge in managing UGH syndrome.