Aphakic and Pseudophakic

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associated with aphakia, but particularly pseudophakia, are important considerations given more than 1.25 million cataract surgeries performed each year.

Glaucoma in this article refers to conditions that cause increased intraocular pressure (IOP) soon after surgery as well as to those conditions that occur much later. Examples include viscoelastic-associated pressure rise measured in hours to ghost cell glaucoma occurring weeks after surgery.

pathophysiology is dependent on mechanism involved and includes the following: distortion of the anterior chamber angle, viscoelastics, inflammation, hemorrhage, pigment dispersion, ghost cell, vitreous in the anterior chamber (AC), pupillary block (pseudophakic/aphakic), malignant glaucoma, and posterior capsulotomy.

United States

Duke-Elder estimated a 12% incidence of postoperative glaucoma in 1969. [1] However, the landscape of postcataract complications has been altered by the advent of the intraocular lens (IOL) and fine wound-closure techniques. In the modern era, the incidence of glaucoma is dependent on both the methodology and the type of IOL used.

For instance, Cinotti has noted an increased incidence of glaucoma after extracapsular cataract extraction (ECCE) (7.5%) as compared to intracapsular cataract extraction (ICCE) (5.7%). [2]

Further, Stark has noted that AC IOL (5.5-6.3%) has been associated with an increased incidence of postoperative IOP elevation over iris-fixation (3.9-4.3%) lens and posterior chamber (PC) IOL (1.6-3.5%). [3] These figures are consistent with those reported by Hoskins, in which he observed 5.5% in AC IOL and 1.6% in PC IOL. [4] However, congenital cataract surgeries are associated with a higher incidence of glaucoma, and data range from 6.1-24%.

Without good IOP control, glaucoma may result in blindness.

This condition may occur at any age after cataract surgery; however, are most commonly found in the elderly population.

The prognosis is dependent on the ability to control the IOP.

For excellent patient education resources, visit eMedicineHealth’s Eye and Vision Center. Also, see eMedicineHealth’s patient education articles Glaucoma OverviewGlaucoma FAQs, and Glaucoma Medications.

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Robert H Graham, MD Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona

Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, Arizona Ophthalmological Society, American Medical Association

Disclosure: Partner received salary from Medscape/WebMD for .

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Martin B Wax, MD Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Research and Development, Head, Ophthalmology Discovery Research and Preclinical Sciences, Alcon Laboratories, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Society for Neuroscience

Disclosure: Nothing to disclose.

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Bradford Shingleton, MD Assistant Clinical Professor of Ophthalmology, Harvard Medical School; Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary

Bradford Shingleton, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthors, Sai Gandham, MD, and DooHo Brian Kim, BA, to the development and writing of this article.

Aphakic and Pseudophakic Glaucoma

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