Avoiding Iatrogenic Glaucoma: A Case of Sulcus Placed Single Piece IOL Rescued by Three Piece Lens Exchange with Cost and Medication-Burden Benefits
Year: 2025
Type: article
Study design: Case Report
Abstract: To describe a rare presentation of secondary glaucoma due to an inverted single-piece monofocal intraocular lens (IOL) implanted in the ciliary sulcus and its successful management by IOL exchange. A 68-year-old female presented with raised intraocular pressure (IOP) and inferior retinal nerve fiber layer (RNFL) defect in the left eye (LE) 13 years after uneventful phacoemulsification. Examination revealed a central posterior capsular defect and an inverted single-piece IOL in the sulcus, causing iris chafing and diffuse trabecular pigmentation. IOP normalized without antiglaucoma medications after exchanging the single-piece IOL for a three-piece IOL. Misdiagnosis as primary open-angle glaucoma can delay appropriate surgical intervention. Sulcus placement of single-piece IOLs is associated with uveitis–glaucoma–hyphema and pigment dispersion syndromes; correct IOL selection and positioning are critical to prevent late-onset secondary glaucoma.
Author: Faheem Raja
Institution: INHS Asvini
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7169508593