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Klin Monbl Augenheilkd 2019; 236(04): 410-411
DOI: 10.1055/a-0829-6121
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Pseudouveitis and Iris Atrophy in Pigment Dispersion Syndrome after Sulcus Implantation of a One-Piece IOL with Square Edge Haptics (SN6AT6)

Pseudouveitis und Irisatrophie beim Pigmentdispersionssyndrom nach Sulkusimplantation einer One-Piece-IOL mit Haptik mit rechtwinkliger Kante (SN6AT6)
Bao Khanh Tran
1   Policlinic, Hopital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
2   Policlinique dʼOphtalmologie, HFR Fribourg Hopital cantonal, Fribourg, Switzerland
,
Kattayoon Hashemi
3   Anterior segment, Hopital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
,
Georgios Kymionis
3   Anterior segment, Hopital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
,
Yan Guex-Crosier
4   Uveitis and Inflammation, Hopital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

received 20 September 2018

accepted 15 December 2018

Publication Date:
14 February 2019 (online)

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Background

Cataract is the leading cause of visual impairment and, consequently, cataract surgery is the most common surgical procedure performed worldwide to restore visual acuity and good quality of life [1]. With modern techniques of small incisions and foldable intraocular lenses (IOLs), cataract surgery has become a “minimally invasive” procedure with fast recovery and minimal complication rate. Most IOLs are designed to be implanted in the capsular bag after uneventful phacoemulsification. In case of complications during surgery, such as anterior capsular tears (with or without posterior extension), posterior capsular rupture, or zonular dehiscence, some of these IOLs can be placed in the sulcus. This technique is performed by most surgeons and has been widely described [2]. Although visual outcome may be similar when correctly executed, sulcus IOL implantation can induce some particular postoperative complications that require specific therapy. Pigment dispersion is the most common finding and has been described by several authors [3], [4]. Indeed, IOLs in the sulcus can mechanically rub against the posterior surface of the iris and provoke pigment dispersion. These pigments can later give rise to ocular hypertension by accumulating in the trabecular meshwork. One-piece IOL with square edge haptics may increase this risk as they tend to have thicker haptics. We report an interesting case where pigment dispersion, ocular hypertension, and iris atrophy were mistakenly treated as a non-granulomatous anterior uveitis.

 

  • References

  • 1 Abraham AG, Condon NG, West Gower E. The new epidemiology of cataract. Ophthalmol Clin North Am 2006; 19: 415-425
    PubMedGoogle Scholar
  • 2 Amino K, Yamakawa R. Long-term results of out-of-the-bag intraocular lens implantation. J Cataract Refract Surg 2000; 26: 266-270
    CrossrefPubMedGoogle Scholar
  • 3 Micheli T, Cheung LM, Sharma S. et al. Acute haptic-induced pigmentary glaucoma with an AcrySof intraocular lens. J Cataract Refract Surg 2002; 28: 1869-1872
    CrossrefPubMedGoogle Scholar
  • 4 LeBoyer RM, Werner L, Snyder ME. et al. Acute haptic-induced ciliary sulcus irritation associated with single-piece AcrySof intraocular lenses. J Cataract Refract Surg 2005; 31: 1421-1427
    CrossrefPubMedGoogle Scholar