ANTERIOR INTRAOCULAR-LENS DISLOCATION AFTER COMBINED CATARACT-EXTRACTION AND TRABECULECTOMY

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.