Treatment of secondary glaucoma caused by dislocation of the intraocular lens

Purpose. To demonstrate, through clinical examples, the effectiveness of a combined treatment for secondary glaucoma associated with an intraocular lens (IOL) dislocation, which involves replacing the IOL and carrying mTSCPC. Material and methods. A 79-year-old woman, Ts., in 2023, for the first time complained of visual impairment and increased IOP in her left eye. In 2013, cataract phacoemulsification with IOL implantation was performed on the left eye at the place of residence, in 2023 the lens was sewn to the sclera, glaucoma was detected in the same year. The man Ch., 69 years old, in 2023, reapplied with an increase in IOP in his right eye. In 2014, a non–penetrating deep sclerectomy with Healaflow drainage was performed on the right eye for pseudoexfoliative glaucoma, later in 2017, cataract phacoemulsification with IOL implantation and laser goniodescemetopuncture. In two cases IOL’s were in decentrated position, it was decided to perform a combined operation with the replacement of the IOL with a lens with pupillary fixation (RSP-3) and mTSCPC. Results.Examination one year after surgery: Patient №1: Visus 0.2 sph -1.75 = 0.6, IOP (pneumotonometry) 11 mmHg on Sol. Timololi 0,5% + Brinzolamidi 1%. Patient №2: Visus 0.6 n/a; IOP (pneumotonometry) 17 mmHg on Sol. Timololi 0,5% + Sol. Brimonidini 0,15%. Conclusion. The combined treatment of secondary glaucoma caused by IOL dislocation is effective due to the hypotensive effect of mTSCPC and the prevention of contact of dislocated IOL with uveal structures, contributing to the preservation of visual functions, normalization of ophthalmotonus and reduction of the number of instillations of antihypertensive drugs. Keywords: dislocation of the intraocular lens, secondary glaucoma, microimpulse transcleral cyclophotocoagulation