title: Reverse pupillary block after implantation of a scleral-sutured posterior chamber intraocular lens: a retrospective, open study.
abstract: BACKGROUND
  To report the clinical features of patients with reverse pupillary block (RPB) after scleral-sutured posterior chamber intraocular lens (PC IOL) implantation and biometric changes after laser peripheral iridotomy (LPI).
  
  
  METHODS
  Eight patients attending our hospital's ophthalmology outpatient clinic, who developed RPB after implantation of a scleral-sutured PC IOL due to subluxation of the crystalline lens or IOL, were investigated in this retrospective, observational study.
  
  
  RESULTS
  Preoperative evaluations showed angle pigmentation in all cases and iridodonesis in 2 cases. Two subjects had used an α1A-adrenoceptor antagonist for benign prostatic hyperplasia. Pars plana or anterior partial vitrectomy was performed in all cases. All eyes showed an extremely deep anterior chamber, a concave iris configuration, and contact between the IOL optic and the iris at the pupillary margin. Pupil capture was detected in 2 cases. The mean (± SD) anterior chamber angle (ACA) was 89.91 ± 10.06°, and the anterior chamber depth (ACD) was 4.42 ± 0.16 mm before LPI. After LPI, the iris immediately became flat with a decreased ACA (51.70 ± 2.59°; P = 0.018) and ACD (4.14 ± 0.15 mm; P = 0.012). After LPI, the intraocular pressure decreased from 19.75 ± 3.77 mmHg to 15.63 ± 4.30 mmHg (P = 0.011), and the spherical equivalent decreased from -0.643 ± 0.385 D to - 0.875 ± 0.505 D (P = 0.016).
  
  
  CONCLUSIONS
  Concomitant vitrectomy, angle pigmentation, and iridodonesis may be risk factors for RPB after scleral-sutured PC IOL implantation. LPI is effective for relieving the RPB.
authors.affiliation: Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56, Dalseong-ro, Jung-gu, 41931, Daegu, South Korea.
authors.forename: Seung Pil
authors.initials: SP
authors.lastname: Bang
authors.affiliation: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Choun-Ki
authors.initials: CK
authors.lastname: Joo
authors.affiliation: Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56, Dalseong-ro, Jung-gu, 41931, Daegu, South Korea. junjonghwa@gmail.com.
authors.forename: Jong Hwa
authors.initials: JH
authors.lastname: Jun
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects
keywords: Laser peripheral iridotomy; Reverse pupillary block; Scleral fixed; Vitrectomy