Surgical outcomes of interventions for treating intraocular lens-induced secondary pigment dispersion syndrome: a retrospective study

Purpose : Intraocular lens (IOL)-induced pigment dispersion syndrome (PDS) represents a significant clinical challenge. However, literature on treatment strategies based on intraocular pressure (IOP) is limited. In this retrospective comparative analysis, we analyzed patients with IOL-induced PDS who underwent surgical treatment, focusing on clinical outcomes and preoperative IOP. Methods : Japanese patients with glaucoma who underwent surgery for IOL-related PDS were divided into the IOL removal with scleral fixation of IOL (SFIOL) and glaucoma surgery groups. The SFIOL group was subdivided into the high- and low- pressure groups based on preoperative IOP. The main outcomes included mean IOP and cumulative success rates assessed using Kaplan–Meier curves. Results : We analyzed 24 eyes (24 patients) in the SFIOL group and 15 (15 patients) in the glaucoma surgery group. In the SFIOL low-pressure group (preoperative IOP ≤24 mmHg), normal IOP was maintained, resulting in a postoperative 1-year cumulative 100% success rate; in the high-pressure group (preoperative IOP >24 mmHg), IOP was challenging to maintain even after IOL status improvement, resulting in a 24.2% success rate. In the glaucoma surgery group (median preoperative IOP 29 mmHg), the success criterion rate for 6 ≤ IOP ≤ 21 mmHg was 100%, and 49.2% for 6 ≤ IOP ≤ 14 mmHg. Conclusion : When preoperative IOP was maintained, normal pressure could be achieved by IOL status improvement. Additional glaucoma surgery was frequently required when preoperative IOP exceeded 24 mmHg. IOL and iris alignment should be corrected when preoperative IOP is maintained at < 24 mmHg.