A New Form of Secondary Acute Angle-Closure Glaucoma: Incidence and Pathogenesis of Acute Ocular Hypertension After Implantation of Phakic Collagen Lenses (ICL)

Abstract

Purpose: : To assess the incidence and to investigate the pathogenic mechanisms of acute ocular hypertension secondary to ICL implantation.

Results: : Fourteen eyes (2.48%) presented acute IOP rise after ICL implantation. Mean IOP during the peak was 43.9 +/- 7.1 mmHg (range: 30 to 52 mmHg). Time from surgery to acute IOP rise was 23.5 +/- 19.6 hours (6 to 72 hours). Among the eyes with ocular hypertension, the vault varied from 0.75 y 5 mm, with a mean of 3.2 ± 0.9 mm. Medical treatment (mydriasis and hypotensive drugs) was sufficient to control 2 eyes (14.2%), enlargement of iridotomies was needed in 5 eyes (35.7%) and exchange/explantation of ICL was performed in 7 eyes (50%). Eyes that needed ICL exchange/explantation had a white to white distance (11.4+/-0.3 mm) that tended to be smaller (p:0.05) than those eyes that were managed successfully with medical and/or laser treatment only (11.8+/-0.3 mm).

Conclusions: : Acute IOP rise after ICL implantation occurred in 2.48% of cases in this series and the two most frequent pathogenic mechanisms were ineffective iridotomies and inadequate ICL size.

Keywords: intraocular pressure • clinical (human) or epidemiologic studies: prevalence/incidence • refractive surgery: complications