Pseudophakic Pupillary Block With Angle-Closure Glaucoma in Diabetic Patients

Weinreb, Robert N.; Wasserstrom, Jeffrey P.; Forman, J.; Ritch, Robert

doi:10.1016/0002-9394(86)90006-1

Cited by 24 publications

(7 citation statements)

References 17 publications

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“…Your registrar wanted to know if a surgical iridectomy is required for the diabetic patient for whom she is planning that rare manual extracapsular extraction. The answer depends on the rate of pupillary block in diabetics; although this specific bit of information is not available in the literature, it can be calculated from the existing data 9 …”

Section: Resultsmentioning

confidence: 99%

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Enter the reverend: introduction to and application of Bayes' theorem in clinical ophthalmology

Thomas

Mengersen

Parikh³

et al. 2011

Clinical &Amp; Experimental Ophthalmology

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Section: Resultsmentioning

confidence: 99%

“…The answer depends on the rate of pupillary block in diabetics; although this specific bit of information is not available in the literature, it can be calculated from the existing data. 9 Probability of pupillary block given diabetes: P (PB | DM) is unknown.…”

Section: Clinical Examplementioning

confidence: 99%

Enter the reverend: introduction to and application of Bayes' theorem in clinical ophthalmology

Thomas

Mengersen

Parikh³

et al. 2011

Clinical &Amp; Experimental Ophthalmology

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show abstract

“…In eyes with posterior chamber IOL, papillary block may be related to excessive postoperative inflammation, with the formation of posterior synechiae [ 9 , 10 ]. This risk is higher in diabetics [ 1 , 8 ], and in angle closure glaucoma [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical peripheral iridectomy via a clear-cornea phacoemulsification incision for pupillary block following cataract surgery in acute angle closure

Fang

Wang

2018

BMC Ophthalmol

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BackgroundTo describe a technique of surgical peripheral iridectomy via a clear-cornea tunnel incision to prevent or treat pupillary block following phacoemulsification.MethodsDescription of technique and retrospective description results in 20 eyes of 20 patients with acute angle closure with coexisting visually significant cataract undergoing phacoemulsification considered at risk of postoperative papillary block as well as two pseudo-phakic eyes with acute postoperative pupillary-block. Following phacoemulsification and insertion of an intraocular lens, a needle with a bent tip was inserted behind the iris through the corneal tunnel incision. A blunt iris repositor was introduced through the paracentesis and placed above the iris to exert posterior pressure and create a puncture. The size of the puncture was enlarged using scissors. For postoperative pupillary block the same technique was carried out through the existing incisions created for phacoemulsification.ResultsPeripheral iridectomy was successfully created in all 22 eyes. At a mean follow-up of 18.77 ± 9.72 months, none of the iridectomies closed or required enlargement. Two eyes had mild intraoperative bleeding and one eye a small Descemet’s detachment that did not require intervention. No clinically significant complications were observed. Visual acuity and IOP improved or was maintained in all patients. The incidence of pupillary block in our hospital was 0.09% overall, 0.6% in diabetics and 3.5% in those with diabetic retinopathy.ConclusionsThis technique of peripheral iridectomy via the cornea tunnel incision can be safely used during phacoemulsification in eyes at high risk of pupillary block or in the treatment of acute postoperative pupillary-block after cataract surgery. The technique is likely to be especially useful in brown iris, or if a laser is not available.

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“…Fibrinous exudate pupillary membrane occlusion and secondary glaucoma are relatively rare complications after cataract surgery with modern techniques and instruments. So far, DM has been proposed as risk factor of pseudophakic pupillary block and angle-closure glaucoma (24, 25). Khor et al (26) reported fibrin pupillary-block glaucoma after phacoemulsification cataract surgery in 4 patients, 3 of whom had DM.…”

Section: Discussionmentioning

confidence: 99%