Glaucoma monitoring in patients with a 'pseudophakic cataract'

Abstract

Purpose: To assess potential problems in monitoring glaucoma status in pseudophakic patients in whom the intraocular lens (IOL) has undergone varying degrees of opacification.

Methods: Data was collected by retrospective review of the notes of such patients, who had received a hydrophilic acrylic IOL, SC-60B-0UV, after primary cataract extraction by phacoemulsification. At first, among these, patients with glaucoma were identified and notes were reviewed to identify problems with patients in whom the IOL had undergone varying degrees of opacification.

Results: A total of 32 eyes with glaucoma were identified to have received the SC-60B-0UV IOL. Of these, 13 IOLs (40.6%) had undergone varying degrees of opacification. Eyes with the opacified IOLs showed decreased visual acuity (2.5 lines of Snellen acuity on average). For these eyes, visual field performance (as determined on automated field analyzers) and optic disc assessments were adversely affected giving a false impression of advanced glaucomatous field loss.

Conclusion: In our experience, glaucoma monitoring is made comparatively more difficult in pseudophakic patients with cloudy IOLs. Problems are encountered during assessment of the glaucomatous optic disc due to poor view of the optic disc. On standard static automated visual fields, these opacified IOLs produce artefactual visual field defects making monitoring glaucoma and subsequent management more difficult.