Abstract

ABSTRACT: The ever-increasing number of cataract extractions followed by insertion of intraocular lenses has resulted in the emergence of a new group of patients with severe glaucoma. A series of 41 patients (45 eyes) referred for evaluation and management of uncontrolled glaucoma in pseudophakia is presented. Glaucoma had preexisted in 23 eyes. Sixteen different mechanisms were responsible for the postoperative glaucoma. Among the 41 patients were three with acquired pigmentary glaucoma. The case report of one of those three demonstrates that nonfixation of an Anis posterior chamber intraocular lens was the means by which iris pigment was dislodged. In all cases medical therapy was instituted or intensified, but resulted in acceptable glaucoma control in only 14 eyes. Laser procedures were used in 24 eyes, and laser therapy followed by medical therapy resulted in control in 19 eyes. The remaining 12 eyes underwent 31 surgical procedures, including three enucleations.