title: Pigment dispersion and chronic intraocular pressure elevation after sulcus placement of 3-piece acrylic intraocular lens.
abstract: A 55-year-old man had phacoemulsification and implantation of a 3-piece acrylic intraocular lens (IOL) (AcrySof MA60AC) in the right eye. One month postoperatively, the intraocular pressure (IOP) was 48 mm Hg and peripheral transillumination defects were noted in the iris circumferentially, with the IOL optic edge visible as a silhouette. Gonioscopy showed dense pigmentation of the trabecular meshwork in the right eye, but in the left eye, only mild trabecular meshwork pigment was seen, along with a concave peripheral iris insertion. At 21 months, the right eye required 3 medications for IOP control. While pigment dispersion has been widely reported after placement of 1-piece acrylic IOLs in the ciliary sulcus, we conclude that in susceptible individuals with a concave peripheral iris insertion, pigment dispersion can occur with sulcus placement of a 3-piece acrylic model despite its thinner optic and angulated haptics.
authors.affiliation: Department of Ophthalmology, University of Washington Medical Center, Seattle, USA.
authors.forename: M Camille
authors.initials: MC
authors.lastname: Almond
authors.forename: Michael C
authors.initials: MC
authors.lastname: Wu
authors.forename: Philip P
authors.initials: PP
authors.lastname: Chen
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D017889:Exfoliation Syndrome / Q000175:diagnosis / Q000209:etiology*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000209:etiology*; D018918:Phacoemulsification; D011474:Prosthesis Design; D014129:Trabecular Meshwork / Q000473:pathology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents