In-the-bag multifocal intraocular lens causing pigment dispersion and refractory secondary ocular hypertension

Pigment dispersion and elevated intraocular pressure (IOP) with sulcus placed hydrophobic acrylic intraocular lenses (IOLs) are described and are rare with in-the-bag IOLs. We report a case of a young lady with elevated IOP and pigment dispersion in one eye following an uneventful phacoemulsification and multifocal IOL implantation. The eye had eccentric capsulorrhexis and localized capsular fibrosis with anterior displacement of the IOL optic, resulting in pigment dispersion. The uncontrolled IOP and continued pigment dispersion were managed with IOL exchange (three-piece IOL) followed by filtration surgery, which helped to resolve the condition successfully.