title: Unusual presentation of angle-closure glaucoma treated by phacoemulsification.
abstract: We report the case of a 70-year-old woman with a history of acute primary angle-closure glaucoma (PACG) in the left eye who, 2 hours after a fundus examination and mydriasis, experienced acutely elevated intraocular pressure (IOP) up to 40 mm Hg in the presence of fully dilated pupil and a patent iridotomy. Gonioscopy revealed appositional angle closure in 3 quadrants. After medical control of the IOP, sutureless cataract surgery was performed, including clear corneal incision, phacoemulsification, and soft acrylic posterior chamber intraocular lens (IOL) implantation. Eighteen months after the operation, improvement of visual acuity, widening of anterior chamber angle, and deepening of anterior chamber depth were found. Intraocular pressures are now normal without medication, even after mydriasis. Modern cataract surgery is an effective treatment for selected patients with appositional angle closure and IOP elevation after acute PACG.
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Jia-Kang
authors.initials: JK
authors.lastname: Wang
authors.forename: Pei-Ching
authors.initials: PC
authors.lastname: Lai
mesh_terms: D000208:Acute Disease; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000209:etiology / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D032801:Iridectomy; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification / Q000379:methods*; D011102:Polyhydroxyethyl Methacrylate; D014792:Visual Acuity
chemical_list: D000959:Antihypertensive Agents; D011102:Polyhydroxyethyl Methacrylate