Pigment release and secondary glaucoma after implantation of single-piece acrylic intraocular lenses in the ciliary sulcus

PURPOSE: To report the association of sulcus,fixated, single-piece hydrophobic acrylic intraocular lenses (HAIOL) with pigment release and secondary glaucoma. DESIGN: Interventional case series. METHODS: HAIOL was implanted in the ciliary sulcus of 20 eyes that developed posterior capsule rupture during phacoemulsification. We analyzed postoperative best-corrected visual acuity, manifest refraction, frequency of intraocular lens malpositioning, and postoperative complications. RESULTS: Postoperative best-corrected visual acuity was 20/40 or better in all eyes. The mean postoperative sphere was -0.5 +/- 0.7 diopters (range +1.25 to -2.00); the mean postoperative cylinder was -1.2 +/- 0.8 diopters (range 0 to -2.50). None of the HAIOLs was decentered or dislocated, and none required repositioning. Seven eyes (35%) developed pigment release; three eyes (15%) developed secondary glaucoma. CONCLUSIONS: Implantation of single-piece HAIOLs in the ciliary sulcus is associated with pigment release and secondary glaucoma. Alternative methods of aphakic correction should be considered.