THE GLAUCOMAS IN APHAKIA AND PSEUDOPHAKIA

Intraocular pressure may become temporarily or permanently elevated at various intervals following cataract surgery. There are several mechanisms by which glaucoma develops as a complication of the cataract extraction itself. The presence of a pseudophakos may or may not contribute to the pathogenesis. Important diagnostic clues include the anterior chamber depth, the presence or absence of an iridectomy, gonioscopic findings, and the appearance of the optic nerve head. Life-long medical treatment is frequently justified, as alternative laser or surgical modalities may not be successful. The exact causes for high failure of filtration surgery in aphakic eyes is not clearly understood; scarring of the conjunctiva, the vitreous, and altered characteristics of the aqueous humor have all been incriminated. Current research to improve surgical success includes the development of effective artificial drainage implants or the use of pharmacologic modulators of wound healing, which promote filtration by preventing scar formation.