Acute angle-closure glaucoma due to iris transfixation of a subluxated posterior chamber intraocular lens-capsular bag complex.
An 80-year-old woman with pseudoexfoliation syndrome developed subluxation of a posterior chamber intraocular lens (IOL)-capsular bag complex due to zonular rupture. She underwent a limited 25-gauge pars plana vitrectomy and iris transfixation of the subluxated IOL-capsule complex. The postoperative course was uneventful until the patient developed acute angle-closure glaucoma 3 weeks postoperatively. Ultrasound biomicroscopy confirmed pupillary block by the IOL-capsule complex. The patient was treated with intraocular pressure-lowering medications and a vitreous tap before a laser peripheral iridotomy could be performed successfully. The vision returned to normal, and the angle closure resolved. We recommend that a prophylactic surgical iridectomy be performed in patients with iris transfixation of a posterior chamber IOL-capsular bag complex.
Rutar
Tina
T
Cornea Service, Department of Ophthalmology, University of California-San Francisco, San Francisco, California 94143, USA. tinarutar@yahoo.com
Hwang
David G
DG
Stamper
Robert L
RL
D000208:Acute Disease; D000369:Aged, 80 and over; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000601:surgery*; D015812:Glaucoma, Angle-Closure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular; D033401:Microscopy, Acoustic; D014792:Visual Acuity