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PURPOSE: To determine the incidence of late inflammatory, membrane formation with pigment precipitates on foldable silicone or poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) after phacoemulsification with or without simultaneous trabeculectomy, and to identify probable causative factors. SETTING: Eye Department, Bnai-Zion Medical Center, and the Faculty of Medicine, the Technion, Haifa, Israel. METHODS: In this retrospective study, 155 eyes (140 patients) were divided into four groups by the surgery performed. Group 1: phacoemulsification combined with trabeculectomy and foldable silicone IOL implantation (12 eyes); group 2: phacoemulsification combined with trabeculectomy and PMMA IOL implantation (15 eyes); group 3: phacoemulsification alone with foldable silicone IOL implantation (66 eyes); group 4: phacoemulsification alone with PMMA IOL implantation (62 eyes). Pre-, intra- and postoperative data were compared. RESULTS: Late inflammatory membranes were found on the anterior surface of 33% of the IOLs in group 1, of 3% in group 3, and of none in groups 2 and 4. Membranes developed three to four months after surgery, were resistant to topical corticosteroid treatment, and required repeated Nd:YAG laser treatments. No correlation with pre-, intra- or postoperative factors was found. CONCLUSIONS: Foldable silicone IOLs may induce late postoperative inflammatory membranes with pigment precipitates, especially after combined phacoemulsification and trabeculectomy.
Dr. Z. Friedman, The Annette & Aron Rozin Department of Ophthalmology, Bnai-Zion Medical Center, Faculty of Medicine, 47 Golomb Street, Haifa 31048; Israel
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)