Glaucoma Progression and Development Following Secondary Intraocular Lens Surgery

Background and Objective: This study aimed to investigate glaucoma progression following secondary intraocular lens (SIOL) implantation by surgical approach. Patients and Methods: This was a single-center retrospective study of 440 eyes that received SIOL implantation, including scleral-sutured, scleral-fixated, anterior chamber, and sulcus-fixated. Glaucoma progression was defined as new diagnosis, procedure for intraocular pressure (IOP) control, or IOP elevation ≥ 24 mmHg or ≥ 5 mmHg above baseline requiring additional medications. Risk factors were assessed using multivariable analysis. Results: Mean age at surgery was 71.3 years and 29.3% of patients had prior glaucoma. Overall, 33.2% developed glaucoma progression. Prior glaucoma (hazard ratio 2.08 [95% CI 1.47–2.94], P < .001) and cystoid macular edema (1.63 [1.06–2.52], P = .026) were associated with glaucoma progression on multivariable analysis. There was no difference in glaucoma progression between scleral-sutured, scleral-fixated, anterior chamber, or sulcus-fixated implantation techniques. Conclusion: Our results suggest that surgeons should use their preferred SIOL implantation technique but closely monitor postoperative IOP.