Intraocular pressure level in glaucomatous and nonglaucomatous eyes after complicated cataract surgery and implantation of an AC-IOL.

The effects of a semiflexible, one-piece, open-loop anterior-chamber intraocular lens (AC-IOL) implanted after intracapsular or extracapsular cataract extraction complicated by posterior-capsular or zonular rupture on intraocular pressure (IOP) level and the control of previous glaucoma were studied in 48 eyes with primary implantation and in 10 eyes with secondary implantation. Fifty-four percent of the eyes with primary implantation had exfoliation syndrome; anterior vitrectomy was performed in 60.4%. An immediate pressure rise (IOP greater than or equal to 30 mm Hg) was observed in 29.3% of the eyes. The long-term IOP level (median follow up, 21.5 months) was less than or equal to 20 mm Hg in 83.7% and between 21 and 29 mm Hg in the remaining 16.3%. In three of the nine glaucomatous eyes, the medication had to be increased; in the remaining six, the IOP could be controlled with the previous or reduced medication or with none at all. In three out of the 49 (6.1%) nonglaucomatous eyes, glaucoma medication was started during the follow up. All of these eyes had exfoliation syndrome and two of the fellow eyes had similar IOPs and were receiving similar medication. The results indicate that the semiflexible, open-loop AC-IOL has little effect on IOP and seems to be a safe alternative, even in glaucomatous eyes, if a posterior chamber lens cannot be used.