title: Laser iridotomy to treat uveitis-glaucoma-hyphema syndrome secondary to reverse pupillary block in sulcus-placed intraocular lenses: Case series.
abstract: OBJECTIVE
  To present cases of uveitis-glaucoma-hyphema (UGH) syndrome due to reverse pupillary block in sulcus-placed posterior chamber intraocular lenses (PC IOLs) that were managed with laser peripheral iridotomy (LPI).
  
  
  METHODS
  Community-based subspecialty clinics.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  A chart review of patients with a sulcus-placed PC IOLs presenting with UGH syndrome and reverse pupillary block with posterior iris bowing as diagnosed by gonioscopy and anterior segment optical coherence tomography was carried out. Laser peripheral iridotomy was performed in the eyes included in the study. The main outcome measure was clinical resolution of UGH syndrome.
  
  
  RESULTS
  The study included 6 eyes of 6 patients with a mean age of 59.8 years (range 43.0 to 66.0 years) who presented with unilateral UGH syndrome a mean of 28.7 months (range 0.3 to 84.0 months) after PC IOL implantation. All patients were previously myopic, with 5 (83.3%) having a history of vitrectomy. The mean axial length was 27.0 mm ± 1.4 (SD). An LPI was used to treat the reverse pupillary block with resultant improvement in iris profile and resolution of UGH syndrome in all eyes. The mean intraocular pressure decreased from 30.5 ± 10.0 mm Hg on 0.5 ± 0.8 glaucoma medications to 15.5 ± 3.2 mm Hg postoperatively on 0.7 ± 1.2 medications.
  
  
  CONCLUSIONS
  The UGH syndrome due to reverse pupillary block occurred after sulcus-placed PC IOLs in susceptible patients, those with axial myopia, and post-vitrectomized eyes. The cases were managed with LPIs.
  
  
  BACKGROUND
  Dr. Ahmed is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA.
authors.forename: Harmanjit
authors.initials: H
authors.lastname: Singh
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA.
authors.forename: Milad
authors.initials: M
authors.lastname: Modabber
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Safran
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA. Electronic address: ikeahmed@mac.com.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D058452:Axial Length, Eye; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D006988:Hyphema / Q000209:etiology / Q000601:surgery*; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000209:etiology; D011681:Pupil Disorders / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013577:Syndrome; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000209:etiology / Q000601:surgery*