Unilateral capsular glaucoma after long-standing bilateral pigmentary glaucoma.
In 1964 we treated a 42-year-old woman diagnosed to have classical bilateral pigment dispersion syndrome combined with an intraocular pressure (IOP) of up to 28 mmHg in both eyes. The patient now has a daughter, also with pigment dispersion syndrome. Miotic treatment brought the IOPs to normal, and 8 years later when the disease was in the inactive phase all treatment could be discontinued. At the age of 67 years, exfoliation deposits became visible in the right eye only, but the IOPs were still below 21 mmHg. Four years later, the pressure of the right eye rose to 31 mmHg. During the next few years all available IOP-lowering medications and laser trabeculoplasty failed, and finally trabeculectomy had to be performed to keep the pressure of the right eye under control and to halt visual field changes, which had already appeared. This case illustrates that development of exfoliation syndrome may take place irrespective of pigment dispersion, and that their simultaneous occurrence may lead to an IOP rise that is resistant to medical therapy and laser trabeculoplasty. It additionally provides further clues to the pathogenesis of capsular glaucoma.
Tarkkanen
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A
Department of Ophthalmology, Helsinki University Central Hospital, Finland. ahti.tarkkanen@pp.kolumbus.fi
Kivelä
T
T
D000328:Adult; D000368:Aged; D018450:Disease Progression; D017889:Exfoliation Syndrome / Q000209:etiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006801:Humans; D017211:Treatment Failure