Late pigmented-membrane formation on silicone intraocular lenses after phacoemulsification with or without trabeculectomy.
OBJECTIVE
To determine the incidence of late inflammatory membrane formation with pigment precipitates on foldable silicone or poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) after phacoemulsification with or without simultaneous trabeculectomy and to identify probable causative factors.


METHODS
Eye Department, Bnai-Zion Medical Center, and the Faculty of Medicine, the Technion, Haifa, Israel.


METHODS
In this retrospective study, 155 eyes (140 patients) were divided into 4 groups by the surgery performed: Group 1, phacoemulsification combined with trabeculectomy and foldable silicone IOL implantation (12 eyes); Group 2, phacoemulsification combined with trabeculectomy and PMMA IOL implantation (15 eyes); Group 3, phacoemulsification alone with foldable silicone IOL implantation (66 eyes); Group 4, phacoemulsification alone with PMMA IOL implantation (62 eyes). Preoperative, intraoperative, and postoperative data were compared.


RESULTS
Late inflammatory membranes were found on the anterior surface of 33% of the IOLs in Group 1, 3% in Group 3, and none in Groups 2 and 4. Membranes developed 3 to 4 months after surgery, were resistant to topical corticosteroid treatment and required repeated neodymium:YAG laser treatments. No correlation with preoperative, intraoperative, or postoperative factors was found.


CONCLUSIONS
Foldable silicone IOLs may induce late postoperative inflammatory membranes with pigment precipitates, especially after combined phacoemulsification and trabeculectomy.
Friedrich
Y
Y
Annette & Aron Rozin Department of Ophthalmology, Bnai-Zion Medical Center, Faculty of Medicine, Haifa, Israel.
Raniel
Y
Y
Lubovsky
E
E
Friedman
Z
Z
D000368:Aged; D002462:Cell Membrane / Q000473:pathology; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D010858:Pigmentation; D019904:Polymethyl Methacrylate; D012189:Retrospective Studies; D012826:Silicone Elastomers / Q000009:adverse effects*; D014130:Trabeculectomy / Q000009:adverse effects*; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate