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Pediatric Cataract Surgery and IOL Implantation pp 225–238Cite as

Intraocular Lens Placement in the Setting of Glaucoma

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Abstract

Glaucoma following cataract surgery and uveitic glaucoma are the most common clinical scenarios in which glaucoma complicates aphakia. In both of these forms of glaucoma, intraocular pressure control takes precedence and may require medical or surgical intervention prior to considering placement of an intraocular lens (IOL). Evidence of long-term pressure control is imperative for preservation of vision and, especially in young children, accurate lens calculations. In the setting of glaucoma, there are special considerations that need to be assessed when placing a secondary IOL in an aphakic eye. Evaluation of the angle and anterior chamber anatomy and recognition of prior glaucoma surgeries are important when deciding whether to place the IOL in the sulcus or within the capsule. Especially in microphthalmia or eyes with a history of uveitis, debulking of the Soemmering ring and placement of the lens within the capsule should be a priority. Additional procedures in order to preserve a prior glaucoma surgery such as a trabeculectomy or glaucoma drainage device may be required to prevent uncontrolled intraocular pressure postoperatively. Importantly, intraocular pressure control should not be compromised in the process of improving visual function with placement of a secondary IOL.

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Authors and Affiliations

  1. Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, OK, USA

    Emily M. Zepeda

  2. Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA

    Brenda L. Bohnsack

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  1. Emily M. Zepeda
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Correspondence to Brenda L. Bohnsack .

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Editors and Affiliations

  1. Department of Ophthalmology, Johns Hopkins Hospital Wilmer Eye Institute, Baltimore, MD, USA

    Courtney L. Kraus

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Zepeda, E.M., Bohnsack, B.L. (2020). Intraocular Lens Placement in the Setting of Glaucoma. In: Kraus, C. (eds) Pediatric Cataract Surgery and IOL Implantation. Springer, Cham. https://doi.org/10.1007/978-3-030-38938-3_22

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  • DOI: https://doi.org/10.1007/978-3-030-38938-3_22

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