Secondary open-angle pigmentary glaucoma resulting from a single-piece hydrophobic intraocular lens in the sulcus

Abstract

The case report of a 68-year-old man with a single-piece hydrophobic intraocular lens (IOL) implanted in the sulcus with posterior capsular rent in the right eye inducing secondary open-angle pigmentary glaucoma without individual hereditary steroid susceptibility. The clinical and diagnostic evaluations of the patient were thoroughly and specifically carried out. The unilateral pseudophakic open-angle pigmentary glaucoma developed in the long course in the context of rubbing of the haptics and optic of a hydrophobic IOL implanted in the sulcus, against the posterior surface of the iris, resulting in pigment dispersion, trabecular inflammation, and aqueous outflow obstruction. Although the clinical findings of our case were very similar to that of pigmentary glaucoma, the distinction between the two conditions was still quite easy, considering that pigmentary glaucoma is a bilateral disorder predominantly affecting young myopic men with Krukenberg's spindle and increased incidence of steroid responsiveness. It has been clearly distinguished from steroid-induced glaucoma based on the pigmented trabecular meshwork.

Keywords: Hydrophobic IOL in sulcus; IOL Induced secondary open-angle pigmentary glaucoma; Posterior capsular rent with IOL; Pseudophakia; Sulcus Fixation Single Piece Intraocular lens; steroid responsiveness.