title: Reverse pupillary block associated with pigment dispersion syndrome after in-the-bag intraocular lens implantation.
abstract: A 61-year-old man with high myopia who had received a systemic α1A-adrenoceptor antagonist had phacoemulsification and in-the-bag intraocular lens implantation in the right eye. One day postoperatively, marked pigment dispersion in the anterior chamber, posterior bowing of the iris, and iridodonesis were noted associated with a subsequent elevation in intraocular pressure (IOP). Pharmacological pupil dilation was effective in reducing pigment dispersion and IOP, and laser peripheral iridotomy was performed to alleviate posterior bowing of the iris. We hypothesize that dynamic changes in the aqueous humor flow by cataract surgery and latent flaccidity of the iris due to the systemic α1A-adrenoceptor antagonist caused reverse pupillary block. High myopia may be another risk factor for this complication.
authors.affiliation: From the Department of Ophthalmology (Itagaki, Kunikata, Hiratsuka, Saito), Hitachi General Hospital, Hitachi, and the Department of Ophthalmology (Oshika), Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: hideo.itagaki.bz@hitachi.com.
authors.forename: Hideo
authors.initials: H
authors.lastname: Itagaki
authors.forename: Toshio
authors.initials: T
authors.lastname: Kunikata
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hiratsuka
authors.forename: Junichiro
authors.initials: J
authors.lastname: Saito
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Oshika
mesh_terms: D001082:Aqueous Humor / Q000502:physiology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications; D018918:Phacoemulsification / Q000009:adverse effects*; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery