Dislocation of an intraocular lens (IOL) with the capsular bag is a late complication of cataract surgery, reported with increasing frequency in recent years. Pseudoexfoliation, uveitis, myopia, and other diseases associated with progressive zonular weakening and capsular contraction are the predisposing conditions. Capsular tension rings probably help but do not prevent this complication. Management includes IOL exchange, replacement with an anterior or a sutured posterior chamber IOL, or suturing the IOL through the bag to the iris or the sclera.

A patients who received AcrySof IOLs that came in the AcryPak had some degree of glistenings. There was also a significant decrease in contrast sensitivity compared with that of fellow eyes with silicone IOLs. The glistenings are likely caused by water vacuoles that form within the lens after hydration within the eyes. Further studies are necessary to assess the exact cause of these glistenings.

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A significant number of pseudophakic patients reported symptoms of dysphotopsia. Patients who received an acrylic IOL with flattened edges were at increased risk of experiencing images associated with edge reflections. The SI-40 lens group, although less than the AcrySof groups, reported a higher incidence of glare than the non-AcrySof groups; however, it also had the highest number of patients still driving at night. The phakic population commonly experienced glare reported as more severe than several of the IOL groups.

Glistenings occurred frequently in AcrySof IOLs, with most cases mild. A larger study of this lens is needed to determine whether severe presentations affect visual function and to understand how glistenings change over time.

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Cataract extraction with posterior chamber intraocular lens implantation is rarely complicated by an acute, sterile, anterior segment inflammation. We report three unrelated cases of acute intraocular inflammation following uncomplicated cataract extraction and posterior chamber intraocular lens placement. A constellation of clinical features were found in these cases. The hallmark of this entity was an acute toxic inflammatory reaction occurring in the anterior segment on the first postoperative day. Typically, widespread corneal edema with diffuse corneal endothelial damage occurred, accompanied by a fixed, dilated pupil with significant iris atrophy and sometimes a severe secondary glaucoma. Since all cultures were negative, the resulting inflammatory processes were not a result of endophthalmitis. We believe that a toxic insult introduced into the anterior chamber at the time of surgery precipitated the acute inflammatory processes seen in these cases.

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