Late onset pupillary block glaucoma following phacoemulsification with posterior chamber intraocular lens implantation

2019 ◽  
Vol 30 (5) ◽  
pp. NP26-NP28
Author(s):  
Natasha Gautam Seth ◽  
Faisal Thattaruthody ◽  
Ajay Jurangal ◽  
Surinder Singh Pandav
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Late Onset ◽  
Visual Outcome ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Pupillary Block ◽  
Flat Anterior Chamber ◽  
The Right

Secondary angle closure in a pseudophakic eye due to pupillary block, more than a decade following phacoemulsification, has not been reported. We managed a 75-year-old female presenting with sudden, painful diminution of vision and raised intraocular pressure in the right eye. The key finding was an almost flat anterior chamber with intraocular lens in normal position clinically as well as on ultrasound biomicroscopy. The posterior chamber was ballooned up by vitreous, which was cleared surgically to restore the anatomy. Meticulous clinical examination augmented by ultrasound biomicroscopy findings helped us to diagnose and manage this case for satisfactory intraocular pressure and visual outcome.

scholarly journals Phacomorphic glaucoma in a high myope with phakic intraocular lens

2019 ◽  
Vol 12 (2) ◽  
pp. e227096
Author(s):  
Talvir Sidhu ◽  
Arjun Desai ◽  
Meghal Gagrani ◽  
Tanuj Dada
Keyword(s):  
Intraocular Lens ◽  
Pressure Control ◽  
Sudden Onset ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Light Perception ◽  
Phakic Intraocular Lens ◽  
Cataractous Lens ◽  
Posterior Chamber Intraocular Lens ◽  
The Right

We report a case of a young, one-eyed woman with high myopia who presented to our emergency department with sudden onset painful diminution of vision in the right eye after undergoing laser treatment. Her right eye had a phakic intraocular lens (pIOL) implantation 4 years back and her left eye had absent light perception. She was diagnosed as right eye lens induced secondary angle closure glaucoma with pIOL touching the corneal endothelium and left eye atrophic bulbi. She was admitted under eye emergency for medical intraocular pressure control followed by pIOL explantation with lens aspiration of the cataractous lens and posterior chamber intraocular lens implantation.

scholarly journals Uveitis–glaucoma–hyphema syndrome with sclera-fixed posterior-chamber two-haptic intraocular lens in a highly myopic eye: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu Du ◽  
Xiangjia Zhu ◽  
Jin Yang ◽  
Yinglei Zhang ◽  
Lei Cai ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Direct Evidence ◽  
Bacterial Culture ◽  
Anterior Segment ◽  
Topical Administration ◽  
Ultrasound Biomicroscopy ◽  
Posterior Chamber ◽  
Blurred Vision ◽  
Case Presentation ◽  
The Right

Abstract Background We report a case of uveitis–glaucoma–hyphema (UGH) syndrome in a highly myopic pseudophakic eye with seemingly normal positioning of a two-haptic intraocular lens (IOL). Case presentation The patient was a 61-year-old woman suffering recurrent episodes of blurred vision, floaters, redness, elevated intraocular pressure (IOP), and pain in the right eye following implantation of a sclera-fixed IOL. The symptoms were alleviated by the systemic and topical administration of IOP-lowering and anti-inflammatory medications. A slit-lamp examination revealed depigmentation and atrophy of the iris, and a quiet anterior chamber in the right eye. Endophthalmitis caused by hypovirulent bacteria and UGH syndrome were both considered. Ultrasound biomicroscopy (UBM) and gonioscopy provided direct evidence of malpositioned IOL haptics, which pushed the root of the iris forward, resulting in persistent mechanical chaffing, the probable cause of UGH syndrome. IOL explantation resolved her symptoms. Negative bacterial culture results for the IOL excluded the possibility of endophthalmitis. Conclusions Heightened awareness of underlying UGH syndrome and prompt UBM are important when doctors encounter a patient with a sclera-fixed IOL suffering from recurrent anterior segment inflammation and elevated IOP.

scholarly journals Outcome of Sclera Fixated Intraocular Lens for Complicated Cataract Surgeries in an Eye Institute, Southwestern Nigeria

2020 ◽  
pp. 1-4
Author(s):  
Ejike Egbu ◽  
◽  
Nelson Igwe ◽  
Patrick Olatunji ◽  
◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
International Classification Of Diseases ◽  
Suture Technique ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Southwestern Nigeria ◽  
Initial Surgery ◽  
Classification Of Diseases

Background: Fixating an intraocular lens to the sclera is a technique for managing aphakia that results from complications of cataract surgery when there is difficulty in placing the intraocular lens in the bag or sulcus due to loss of capsular support for the posterior chamber intraocular lens. The procedure involves various techniques aimed at securing an intraocular lens to the sclera to restore sight in the aphakic eye. This is a report of the outcome of 19 cases performed at Eleta Eye Institute, Ibadan, Nigeria and St Mary’s Catholic Eye Hospital Ago Iwoye, Nigeria between April 2018 and February 2019, in which posterior chamber intraocular lenses were fixated to the sclera using polypropylene 10/0 sutures and subjects followed up for six months. Blindness and vision impairment was classified according to the international classification of diseases, ICD-10 for distance vision. Relevant data was retrieved from the medical records of the patients and analyzed using SPSS version 22. Results: The age range was 27-88 years. Posterior capsule rupture from initial surgery accounted for 68.42% of the cases while traumatic cataract accounted for 15.79%. Weak zonules and dislocated intraocular lens accounted for 10.53% and 5.26% respectively. At 24 weeks, there was 89.5% reduction in the number of blind eyes (VA less than 3/60), with 68.4% achieving VA of 6/6-6/12 with pin hole. All the eyes had intraocular pressure ranging between 10 and 22mmHg preoperatively. Postoperatively, temporary hypotony and transient corneal oedema occurred in 8(42.11%) and 6 (31.58%) of the cases respectively, while raised intraocular pressure occurred in 1 (5.2%) of cases. The patient with elevated intraocular pressure was further managed by a glaucoma specialist. Conclusion: The anchor suture technique in combination with the L-shaped scleral flap provides satisfactory visual outcome in managing aphakia or pseudoaphakia and ensures that sutures do not irritate the ocular surface thereby reducing postoperative inflammation. When a PCIOL is used, it eliminates the challenges of stocking of SFIOLs in low resource settings.

Late-onset malignant glaucoma

2020 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Ramiro José Daud ◽  
Horacio Freile ◽  
Mauricio Freile ◽  
Soledad Mariano
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Acute Pain ◽  
Late Onset ◽  
Slit Lamp ◽  
Normal Range ◽  
Slit Lamp Examination ◽  
Complete Occlusion ◽  
Malignant Glaucoma ◽  
The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

2021 ◽  
pp. 112067212110121
Author(s):  
Guido Barosco ◽  
Roberta Morbio ◽  
Francesca Chemello ◽  
Roberto Tosi ◽  
Giorgio Marchini
Keyword(s):  
Visual Impairment ◽  
Cataract Extraction ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Increased Risk ◽  
The Right ◽  
End Stage

Purpose: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection. Methods: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient’s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy. Results: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy. Conclusions: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.

scholarly journals Minimally Invasive Surgery for Intraocular Lens Removal and Intrascleral Intraocular Lens Fixation with Trabeculectomy in a Patient with Dislocated Intraocular Lens and Elevated Intraocular Pressure

2021 ◽  
pp. 538-542
Author(s):  
Yuko Mano ◽  
Kei Mizobuchi ◽  
Tomoyuki Watanabe ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Combined Therapy ◽  
Swept Source ◽  
Needle Technique ◽  
Elevated Intraocular Pressure ◽  
Anterior Segments ◽  
The Right ◽  
End Stage

A 88-year-old female who was being treated for end-stage pseudoexfoliation syndrome was referred to our hospital for treatment of dislocated intraocular lens (IOL) and the elevated intraocular pressure (IOP) and in the right eye (RE). At the first visit to our hospital, best-corrected visual acuity (BCVA) was 0.2 in the RE and 0.02 in the left eye (LE). IOP was 47 mm Hg in the RE and 21 mm Hg in the LE. Slit-lamp examination showed no abnormalities in anterior segments and dislocated IOL in the RE. Fundus photograph showed optic disc pallor in both eyes. We performed the combined therapy of flanged intrascleral IOL fixation with the double-needle technique and trabeculectomy. Throughout the follow-up period, BCVA slightly improved from 0.2 to 0.4 in the RE. The angle of tilt of the IOL was 6.6, 7.9, and 8.7° as measured by swept-source optical coherence tomography at 1, 4, and 6 months after the surgery, respectively. The IOP remained less than 10 mm Hg without having to administer any other glaucoma medications. Furthermore, any complications associated with the surgery were not confirmed.

scholarly journals A Case of Repeating Transient Increase in Intraocular Pressure by Instability of an Intraocular Lens Implanted in the Capsular Bag

2020 ◽  
Vol 11 (1) ◽  
pp. 60-67
Author(s):  
Yukihisa  Takada ◽  
Takayoshi Sumioka ◽  
Nobuyuki Ishikawa ◽  
Shingo Yasuda ◽  
Ryoko Komori ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
University Hospital ◽  
Angle Closure ◽  
Light Reaction ◽  
Narrow Angle ◽  
Medical University

We observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused repeated acute angle-closure glaucoma-like attacks. The situation was well treated by suturing and fixing the haptics of IOL to the sclera.

scholarly journals Late-onset angle closure in pseudophakic eyes with posterior chamber intraocular lenses

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Brian D. Krawitz ◽  
Poonam Misra ◽  
Srilaxmi Bearelly ◽  
Lama A. Al-Aswad
Keyword(s):  
Late Onset ◽  
Intraocular Lenses ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Onset Angle
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