Late onset pupillary block glaucoma following phacoemulsification with posterior chamber intraocular lens implantation

Abstract

Secondary angle closure in a pseudophakic eye due to pupillary block, more than a decade following phacoemulsification, has not been reported. We managed a 75-year-old female presenting with sudden, painful diminution of vision and raised intraocular pressure in the right eye. The key finding was an almost flat anterior chamber with intraocular lens in normal position clinically as well as on ultrasound biomicroscopy. The posterior chamber was ballooned up by vitreous, which was cleared surgically to restore the anatomy. Meticulous clinical examination augmented by ultrasound biomicroscopy findings helped us to diagnose and manage this case for satisfactory intraocular pressure and visual outcome.

Predisposing Factors for Severe Complications after Cataract Surgery: A Nationwide Population-Based Study

“…We speculate two possible reasons for the high rate of postoperative glaucoma in the current study. Firstly, the development of acute intraocular pressure spike, pseudophakic pupillary block, and malignant glaucoma during the postoperative period may account for the majority of postoperative glaucoma episodes which were also reported in previous studies [47,48]. These acute events may be different from the classic glaucoma associated with a chronic or persistent disease course, but they can definitively lead to optic nerve damage.…”

Ultrasound biomicroscopy in the management of complex cataract and intraocular lens: A review

“…Pupillary block may sometimes present in pseudophakic eyes from seclusio pupillae and iris bombe (Figure 34) such as in uveitic or paediatric eyes with exuberant postoperative inflammatory response, or from occlusio pupillae (Figure 35) due to pupillary membranes or vitreous prolapse 79 . Aphakic eyes may also develop spontaneous pupillary block via a similar mechanism of close apposition between the intact hyaloid and posterior iris surface.…”