INTRAOCULAR-PRESSURE CHANGES AFTER PHACOEMULSIFICATION AND FOLDABLE SILICONE LENS IMPLANTATION USING HEALON GV(R)

The authors studied the intraocular pressure (IOP) changes after phaco emulsification with two different kinds of foldable silicone lens impl antation using Healon GV(R) as viscoelastic substance. One hundred pat ients undergoing cataract surgery were enrolled in this study Inclusio n criteria were: absence of ocular Phacoemulsification hypertension or glaucoma. Patients were randomly assigned to plate haptic (Silens PH( R), Domilens(R) Chiron Vision,Lyon, France) or three-piece (CeeOn(TM) 920, Pharmacia spa, Milano, Italia) silicone intraocular lens (IOL) im plantation. Following phacoemulsification and cortical aspiration, the capsular bag was reinflated with Healon CV; After foldable silicons I OL insertion residual Healon GV was removed from the anterior chamber. IOP was measured preoperatively and at 6, 24 h and 1 week postoperati vely. Six hows postoperatively IOP was higher in the Silens PW group t han in the CeeOn group (20.85+/-5.42, vs. 18.88+/-2.95 mm HE, p = 0.02 6). The difference was confirmed after 24 h (21.02+/-5.18 vs. 17.34+/- 3.18 mm Hg, p<0.01). Despite the medical treatment (acetazolamide 250 mg orally every 6 hr) at the 24-hour control 2 eyes with plate haptic silicone lens showed IOP values higher than 30 mm Hg. Slitlamp examina tion showed in both eyes a shallowing of the anterior chamber together with the evidence of capsular bag hyperdistension and capsular block resulting from the occlusion of the circular anterior capsule opening by the plate haptic IOL. Residual Healon GV removal from the anterior chamber was performed. At 1-week control both eyes showed normalizatio n. of IOP. The use of a plate haptic silicone lens may be associated w ith a more consistent retention of Healon CV in the eye with trapping in the capsular bag. Retained viscoelastic may cause either trabecular meshwork blockage by viscoelastic substance or postoperative capsular bag hyperdistension, anteroplacement of the IOL optic and capsular bl ock from occlusion of the circular anterior opening by the IOL optic.