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(Br_t Ophthalmol 1995; 79: 807-808)

In this population based study we have reviewed the files of all patients who underwent an extracapsular cataract extraction (ECCE) between 1984 and 1987, were normotensives prior to surgery, and were followed up for at least 10 months after the ECCE. From a total of 1047 operations 746 qualified for the inclusion criteria; of these, 16 (2.1%) were found to have a consistently raised intraocular pressure (>21 mmHg) on more than two occasions) at four months or later after surgery and throughout at least a sixmonth period. An The term 'aphakic glaucoma' has been discontinued because a variety of different conditions have been included under this name. For the same reasons we prefer the term 'persistently elevated IOP', but for the purpose of this study, the shorter name 'secondary aphakic glaucoma (SAG)' has been used. Little information could be found in the literature as to the incidence of SAG. The available reports indicate incidence rates varying between 1 and 7%.'15 These wide variations are due to the diversity of the surgical procedures (intra-or extracapsular) employed in each study and the variety of the intraocular lenses used by the different authors -anterior chamber (AC), iris plane (IP), or posterior chamber (PC). The differences may also be caused by the varying numbers of cases in each study -100' to 23824 -or the extent of the followup. Furthermore, some of the studies date back to the days when the microscope was not the standard for cataract surgery, and also the methods of study were other than those used today.Owing to the need for an epidemiological study of the incidence of SAG we undertook to review our data derived from a series of patients who underwent ECCE during a given time in the Negev region of southern Israel. The cataract surgery was performed whenever possible under retrobulbar anaesthesia. The surgeons included all staff members from residents in training to senior faculty.The conjunctival flap was fornix-based. Viscoelastic material was always used, both during the anterior capsulotomy and the IOL insertion.