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Purpose <p>To evaluate outcomes of surgical interventions for intraocular lens-induced secondary pigment dispersion (IOL-SPD) and examine how preoperative intraocular pressure (IOP) informs treatment choice.</p> Methods <p>We conducted a retrospective comparative study of two strategies: (1) the scleral fixation of IOL (SFIOL) group underwent IOL-status improvement only (IOL removal with SFIOL and pars plana vitrectomy), and (2) the Ahmed Glaucoma Valve (AGV) group underwent the same IOL-status improvement plus glaucoma surgery with AGV (AGV insertion was the only glaucoma procedure performed). The SFIOL group was subdivided into low-pressure (preoperative IOP ≤ 24 mmHg) and high-pressure (preoperative IOP &gt; 24 mmHg) subgroups. Main outcomes included mean IOP and cumulative success rates assessed using Kaplan–Meier curves.</p> Results <p>We analyzed 24 (24 patients) and 15 (15 patients) eyes in SFIOL and AGV groups. In the SFIOL low-pressure group, normal IOP was maintained, resulting in a postoperative 1-year cumulative 100% success rate; in the high-pressure group, IOP was challenging to maintain even after IOL-status improvement, resulting in a 24.2% success rate. In the AGV group (median preoperative IOP 29&#xa0;mmHg), the success criterion rate was 100% for 6 ≤ IOP ≤ 21&#xa0;mmHg and 49.2% for 6 ≤ IOP ≤ 14&#xa0;mmHg. The SFIOL group was analyzed up to 12&#xa0;months, and the AGV group, up to 24&#xa0;months.</p> Conclusion <p>When preoperative IOP was ≤ 24&#xa0;mmHg, IOL-status improvement was associated with normal IOP maintenance at 12&#xa0;months. When preoperative IOP was &gt; 24&#xa0;mmHg, additional glaucoma surgery was frequently required despite IOL-status improvement. IOL–iris alignment correction may be considered while IOP remains ≤ 24&#xa0;mmHg.</p>

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Surgical outcomes of interventions for treating intraocular lens-induced secondary pigment dispersion syndrome: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Shuu Morita,
  • Tatsuya Fujii,
  • Yoshihito Sakanishi,
  • Ayumi Usui-Ouchi,
  • Shintaro Nakao,
  • Nobuyuki Ebihara

摘要

Purpose

To evaluate outcomes of surgical interventions for intraocular lens-induced secondary pigment dispersion (IOL-SPD) and examine how preoperative intraocular pressure (IOP) informs treatment choice.

Methods

We conducted a retrospective comparative study of two strategies: (1) the scleral fixation of IOL (SFIOL) group underwent IOL-status improvement only (IOL removal with SFIOL and pars plana vitrectomy), and (2) the Ahmed Glaucoma Valve (AGV) group underwent the same IOL-status improvement plus glaucoma surgery with AGV (AGV insertion was the only glaucoma procedure performed). The SFIOL group was subdivided into low-pressure (preoperative IOP ≤ 24 mmHg) and high-pressure (preoperative IOP > 24 mmHg) subgroups. Main outcomes included mean IOP and cumulative success rates assessed using Kaplan–Meier curves.

Results

We analyzed 24 (24 patients) and 15 (15 patients) eyes in SFIOL and AGV groups. In the SFIOL low-pressure group, normal IOP was maintained, resulting in a postoperative 1-year cumulative 100% success rate; in the high-pressure group, IOP was challenging to maintain even after IOL-status improvement, resulting in a 24.2% success rate. In the AGV group (median preoperative IOP 29 mmHg), the success criterion rate was 100% for 6 ≤ IOP ≤ 21 mmHg and 49.2% for 6 ≤ IOP ≤ 14 mmHg. The SFIOL group was analyzed up to 12 months, and the AGV group, up to 24 months.

Conclusion

When preoperative IOP was ≤ 24 mmHg, IOL-status improvement was associated with normal IOP maintenance at 12 months. When preoperative IOP was > 24 mmHg, additional glaucoma surgery was frequently required despite IOL-status improvement. IOL–iris alignment correction may be considered while IOP remains ≤ 24 mmHg.