Secondary Glaucoma and Single-Piece Acrylic IOL Implantation in the Ciliary Sulcus

O pen-angle glaucomas are typically classified as either primary or secondary. Primary open-angle glaucoma is a diagnosis of exclusion, characterized by an open anterior chamber angle and lack of a secondary, contributing disease process. Secondary glaucomas are related to an underlying disease that causes increased resistance to trabecular meshwork out flow and subsequent intraocular pressure rise. Examples of secondary glaucomas include the pigmentary, phacolytic, steroid-induced, exfoliation, neovascular, and angle-recession types. An important cause of pigmentary glaucoma relates to pigment release from the posterior iris surface due to direct contact with an improperly positioned IOL in the ciliary sulcus. This article highlights the nature of this process and includes recommendations for prevention and management.