Noncicatricial oval deformation of the pupil induced by sulcus-fixated one-piece posterior chamber lenses

A retrospective analysis of 40 cases of sulcus-fixated one-piece poly(methyl methacrylate) posterior chamber lenses revealed ten cases (25%) that demonstrated oval deformation of the pupil, similar to the condition associated with anterior chamber lenses. This complication was not noted until several weeks after surgery, appears to be progressive, and might be the cause of glare symptoms. Possible mechanisms of the pupillary deformation include mechanical stretching of the iris by oversized lenses and fibroproliferation on the posterior iris surface. Prevention rests upon firm capsular bag fixation aided by capsulorhexis and reduction of the overall lens loop diameter.