Hj. Shammas, ANTERIOR INTRAOCULAR-LENS DISLOCATION AFTER COMBINED CATARACT-EXTRACTION AND TRABECULECTOMY, Journal of cataract and refractive surgery, 22(3), 1996, pp. 358-361
Purpose: To evaluate the incidence, cause, and effect of intraocular l
ens (IOL) dislocation after combined cataract extraction and trabecule
ctomy. Setting: An ophthalmic ambulatory surgery center in Lynwood, Ca
lifornia. Methods: This retrospective study comprised 150 patients wit
h open-angle glaucoma who had either planned extracapsular cataract ex
traction (ECCE) (n = 96) or phacoemulsification (n = 54) combined with
IOL implantation and trabeculectomy. I reviewed type of cataract extr
action, 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 capsulo-hexis (3.7%). E
ighteen of 30 eyes (60%) that had excessive filtration also had IOL di
slocation. Mean induced postoperative myopia in eyes with lens disloca
tion was -2.25 diopters (D) +/- 0.55 (SD). Conclusions: Anterior IOL d
islocation was related to increased postoperative filtration and was m
ore common after planned ECCE, In all cases, it caused a distorted pup
il, posterior synechias, and induced myopia of over -1.00 D.