Repeated pupillary capture and pigmentary glaucoma after implantation of reversed three-piece sulcus intraocular lens

Abstract

A 58-year-old man underwent phacoemulsification, anterior vitrectomy, and areversed three-piece intraocular lens placement in the sulcus. He developed pseudophakic pupillaryblock with optic capture of the intraocular lens four months later and underwent intraocularlens repositioning combined with surgical iridectomy. After 18 months, he had elevated intraocularpressure that was thought to be secondary to complicated cataract surgery, and he wasprescribed topical glaucoma medications. He had poor adherence and follow-up attendance.After another six months, he presented to the Baylor College of Medicine, Houston, USA, withan intraocular pressure of 30 mmHg and advanced pigmentary glaucoma. The intraocular lensoptic was captured by the pupil after dilation. A trabeculectomy and intraocular lens exchangewas performed. Reversed intraocular lens in the sulcus may present as repeated intraocular lenspupillary capture and result in the development of pigmentary glaucoma.