title: Elevated intraocular pressure in secondary piggyback intraocular lens implantation.
abstract: We report 2 cases of postoperative intraocular pressure (IOP) elevation in secondary piggyback intraocular lens (IOL) implantation without history of glaucoma or ocular hypertension. A 74-year-old woman with myopic pseudophakia and a 68-year-old man with hyperopic pseudophakia received secondary piggyback AcrySof IOL implantation in their left eyes. In both patients, the left IOP gradually increased and sustained around 30 mm Hg for about 1 year. In the first, IOP continued elevating despite topical and systemic medications. There was an episode of pupillary block in the second. Gonioscopically, heavier trabecular meshwork pigmentation in their left eyes was observed. Because of this, the 2 IOLs implanted were removed and replaced by an adequate IOL and trabeculotomy was performed in the former. The AcrySof IOL has a truncated optic edge, which increases the risk for chafing the iris, resulting in pigment dispersion syndrome; thus, it would be a poor choice for a sulcus-placed piggyback implantation.
authors.affiliation: Department of Ophthalmology, Toyama Prefectural Central Hospital, Toyama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwase
authors.forename: Nobushige
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000180:Acrylic Resins; D000368:Aged; D020878:Device Removal; D005260:Female; D006068:Gonioscopy; D006801:Humans; D006956:Hyperopia / Q000150:complications / Q000601:surgery; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D009216:Myopia / Q000150:complications / Q000601:surgery; D009798:Ocular Hypertension / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications; D011474:Prosthesis Design; D019591:Pseudophakia / Q000150:complications / Q000601:surgery; D014130:Trabeculectomy
chemical_list: D000180:Acrylic Resins