Incidence of anterior intraocular lens precipitates after combined phacotrabeculectomy

Purpose: To compare the incidence of anterior intraocular lens (IOL) precipitates on silicone and poly(methyl methacrylate) (PMMA) IOLs after phacotrabeculetomy. Setting: District general hospital in the United Kingdom. Methods: Ninety-five consecutive eyes of 77 patients who had combined phacotrabeculectomy between April 1992 and October 1996 were retrospectively studied. A slitlamp biomicroscope was used to look for precipitates. Results: Mean patient age was 75 years (range 51 to 89 years). Preoperatively, mean intraocular pressure (IOP) was 26 mm Hg +/- 5.26 (SD). Thirty plate-haptic silicone IOLs and 65 PMMA IOLs were implanted. Six months postoperatively, median corrected Snellen acuity improved from 6/18 to 6/9. The mean number of antiglaucoma medications dropped from 1.46 preoperatively to 0.29 postoperatively; 73 eyes (76.8%) had an IOP of less than 22 mm Hg with no medication. In 1 surgeon's experience, lens precipitates appeared in 10 of 59 cases (16.9%), with 7 of 14 (50.0%) in the silicone IOL group and 3 of 45 (6.7%) in the PMMA IOL group. The difference was statistically significant (P < .001, chi-square). Conclusion: The incidence of anterior IOL precipitates was significantly higher in patients with a silicone IOL than in those with a PMMA IOL, suggesting that use of silicone IOLs may increase the incidence of postoperative IOL precipitates. J Cataract Refract Surg 2000; 26:398-401 (C) 2000 ASCRS and ESCRS.