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Anterior intraocular lens dislocation after combined cataract extraction trabeculectomy
1School of Medicine, University of Southern California, Los Angeles, USA.
Purpose:
To evaluate the incidence, cause, and effect of intraocular lens (IOL) dislocation after combined cataract extraction and trabeculectomy.
Setting:
An ophthalmic ambulatory surgery center in Lynwood, California.
Methods:
This retrospective study comprised 150 patients with open-angle glaucoma who had either planned extracapsular cataract extraction (ECCE) (n = 96) or phacoemulsification (n = 54) combined with IOL implantation and trabeculectomy. I reviewed type of cataract extraction, preoperative glaucoma medications, axial length, and amount of filtration achieved postoperatively.
Results:
The lens dislocated in 20 eyes (13.3%), with the highest incidence after planned ECCE (18.7%) and the lowest after phacoemulsification with capsulorhexis (3.7%). Eighteen of 30 eyes (60%) that had excessive filtration also had IOL dislocation. Mean induced postoperative myopia in eyes with lens dislocation was-2.25 diopters (D) +/- 0.55 (SD).
Conclusions:
Anterior IOL dislocation was related to increased postoperative filtration and was more common after planned ECCE. In all cases, it caused a distorted pupil, posterior synechias, and induced myopia of over -1.00 D.