Acute angle closure after implantable contact lens insertion unresponsive to surgical peripheral iridectomy.
We present a case of acute angle closure that occurred after insertion of an implantable contact lens (ICL). The apparent papillary-block angle closure did not resolve after 2 patent iridotomies and a surgical iridectomy, but did respond to pupil dilation (not constriction). Ultrasound biomicroscopy revealed abnormally large and irregular ciliary processes that may have contributed to the unusual behavior of the ICL-iris complex. The condition resolved after the ICL was replaced by one with a smaller haptic diameter. Routine ultrasound biomicroscopic assessment of the ciliary body anatomy preoperatively and ICL haptic positioning postoperatively may identify risk factors that could predispose ICL patients to acute angle closure.
Chan
Kenneth C Y
KC
Eye Department, Wellington School of Medicine, Wellington, New Zealand. dr.kenneth.chan@gmail.com
Birchall
Wayne
W
Gray
Trevor B
TB
Wells
Anthony P
AP
D000208:Acute Disease; D000328:Adult; D002924:Ciliary Body / Q000002:abnormalities / Q000000981:diagnostic imaging; D020878:Device Removal; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D033401:Microscopy, Acoustic; D009184:Mydriatics / Q000008:administration & dosage; D047728:Myopia, Degenerative / Q000601:surgery; D011680:Pupil / Q000187:drug effects; D011681:Pupil Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D014331:Tropicamide / Q000008:administration & dosage
D009184:Mydriatics; D014331:Tropicamide