Implantation of single-piece hydrophobic acrylic intraocular lens in the ciliary sulcus

Objective
To report the association of sulcus-fixated, single-piece hydrophobic acrylic
intraocular lenses (HAIOL) with pigment-dispersion syndrome (PDS) and
pigmentary glaucoma (PG).

Methods

This is a noncomparative consecutive case series of 20 eyes that underwent
sulcus implantation of a single-piece HAIOL after posterior-capsule rupture
(PCR) during phacoemulsification. The following data were analyzed:
postoperative best-corrected visual acuity (BCVA); manifest refraction;
frequency of IOL decentration, dislocation, and repositioning; intraocular
pressures; gonioscopic findings; and postoperative complications.

Results
The postoperative BCVA was 20/40 or better in all eyes. The mean
postoperative sphere was –0.05 ± 0.7 diopters (range, +1.25 to –2.00) and the
mean postoperative cylinder was –1.2 ± 0.8 diopters (range, 0 to –2.50). None
of the HAIOLs became decentered, dislocated, or required repositioning.
Seven eyes (35%) developed PDS while 3 eyes (15%) developed PG that
required IOP-lowering medications or filtering surgery. The average followup period was 17.2 ± 9.4 months (range, 6 to 36).

Conclusion
Implantation of single-piece HAIOLs in the ciliary sulcus is associated with
PDS and PG. Alternative methods of aphakic correction should be considered
in cases of PCR.

Keywords: Ciliary sulcus, Hydrophobic acrylic intraocular lenses, Pigment-dispersion syndrome,
Pigmentary glaucoma, Aphakic correction