Role of ultrasound biomicroscopy in managing pseudophakic pupillary block glaucoma

Sathish, Srinivasan; MacKinnon, Jane R.; Atta, H R

doi:10.1016/s0886-3350(00)00520-4

Cited by 20 publications

(9 citation statements)

References 5 publications

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“…7 This technique has been used to determine IOL positioning in the past and to elucidate the cause of reverse pupillary block. 8–10 In a case study by Sathish et al, 10 anterior segment UBM helped to diagnose iris bombe as the cause of pseudophakic pupillary block glaucoma 3 years after implantation of a 3-piece IOL in the bag 8 . In our case, while the configuration of the haptic provided a clue as to the etiology of pupillary block, anterior segment UBM confirmed that the IOL was causing anterior bowing of the iris and helped to exclude other causes such as aqueous misdirection syndrome, 11 bilateral ring cysts of the ciliary body, 8 late-onset secondary pigmentary glaucoma, 9 a thick Soemmerring ring, and anterior displacement of the ciliary body.…”

Section: Discussionmentioning

confidence: 99%

Pupillary block due to reverse implantation of a sulcus intraocular lens

Zhang

Soni

Alexander

et al. 2016

Journal of Cataract and Refractive Surgery Online Case Reports

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An 88-year-old woman with a history of complicated cataract extraction by phacoemulsification with sulcus intraocular lens (IOL) placement developed pseudophakic pupillary block after reverse implantation of the IOL. In the postoperative period, she had persistently elevated intraocular pressures (IOP) and was diagnosed with chronic angle-closure glaucoma that was treated medically. She presented 5 years later with acute pupillary block. The diagnosis of reverse IOL implantation was confirmed by ultrasound biomicroscopy. An IOL repositioning, anterior synechialysis, and Baerveldt tube shunt placement led to resolution of the pupillary block and a well-controlled IOP.

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Section: Discussionmentioning

confidence: 99%

Pupillary block due to reverse implantation of a sulcus intraocular lens

Zhang

Soni

Alexander

et al. 2016

Journal of Cataract and Refractive Surgery Online Case Reports

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“…Secondly, a 2003 ASCRS survey 2 showed that 72% of small incision cataract surgery was performed through a clear corneal section with only 28% through a scleral tunnel (no UK data available). The cohort of Lindfield et al 1 had a disproportionately high percentage of scleral tunnel patients compared with likely current standard practice.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…The value of HFU in cases of pseudophakic pupillary block and other post-operative ciliary body abnormalities was demonstrated by us in previous publications. 2,3 Anterior segment OCT is an 'optical scan' and therefore obeys the simple optical principle of inability to penetrate through opaque media. This is the domain of ultrasound.…”

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confidence: 99%

Comment on ‘Idiopathic uveal effusion syndrome causing unilateral acute angle closure in a pseudophakic patient’

Atta

2012

Eye

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“…Laser peripheral iridotomy will result in iris flattening by relieving the anterior–posterior chamber pressure differential. UBM has been shown to be of value in elucidating the etiology of pupillary block glaucoma [34,36,37]. UBM can also be useful for the diagnostic imaging of malignant glaucoma (Figure 4), which is characterized by a forward movement of the iris–lens diaphragm and a very shallow anterior chamber, typically following glaucoma surgery, chronic angle-closure glaucoma or pseudoexfoliation [38].…”

Section: Clinical Application Of Ubm and As-oct For Glaucoma Diagnosis mentioning

confidence: 99%

Anterior-segment imaging for assessment of glaucoma

Ursea¹,

Silverman²

2010

Expert Review of Ophthalmology

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This article summarizes the physics, technology and clinical application of ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT) for assessment of the anterior segment in glaucoma. UBM systems use frequencies ranging from approximately 35 to 80 MHz, as compared with typical 10-MHz systems used for general-purpose ophthalmic imaging. OCT systems use lowcoherence, near-infrared light to provide detailed images of anterior segment structures at resolutions exceeding that of UBM. Both technologies allow visualization of the iridocorneal angle and, thus, can contribute to the diagnosis and management of glaucoma. OCT systems are advantageous, being noncontact proceedures and providing finer resolution than UBM, but UBM systems are superior for the visualization of retroiridal structures, including the ciliary body, posterior chamber and zonules, which can provide crucial diagnostic information for the assessment of glaucoma. †Author Glaucoma is a disease that is essentially an optic neuropathy. Great strides have been made in the last decade in imaging the retinal nerve fiber layer and the optic nerve using optical coherence tomography (OCT). OCT is a noninvasive technique allowing the visualization and measurement of these structures for the assessment of glaucoma progression [1][2][3][4][5]. While damage to the optic and retinal nerves is responsible for the degradation of vision, in most instances this damage is associated with elevated intraocular pressure (IOP). Elevation of IOP results from an imbalance between the production and drainage of aqueous fluid, specifically, increased outflow resistance. Thus, assessment of the anterior segment plays a major role in the diagnosis and treatment of glaucoma.The traditional tools for the assessment of the angle and anterior segment are the slit-lamp and gonioscopy, in combination with a Goldmann contact lens and classification using the system introduced by Shaffer [6]. Several newer technologies now exist for imaging of the anterior segment, including scanning Scheimpflug (e.g., Pentacam, Oculus, Inc., Lynnwood, WA, USA), and scanning slit-lamp systems (e.g., Orbscan, Orbtek Inc., Salt Lake City, UT, USA). The Pentacam can provide rapid and reproducible measurements of anterior chamber depth and angle width [7], but is limited to visualization of only the angle approach. Scheimpflug photography also does not display the retroiridal structures or the ciliary body, which are of great interest in glaucoma diagnosis [8]. The scanning peripheral anterior chamber depth analyzer is another optically based system. It has high reproducibility in screening for narrow angles, as with other systems using visible light, but may have difficulty in assessing the bottom of the angle, as can be accomplished by OCT and ultrasound biomicroscopy (UBM) [9]. While these visible light systems are undoubtedly useful, especially for screening for narrow angles, OCT (based on near-infrared light) and UBM systems allow imaging of the full-angle anatomy and, in the cas...

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Role of ultrasound biomicroscopy in managing pseudophakic pupillary block glaucoma

Cited by 20 publications

References 5 publications

Pupillary block due to reverse implantation of a sulcus intraocular lens

Pupillary block due to reverse implantation of a sulcus intraocular lens

Comment on ‘Idiopathic uveal effusion syndrome causing unilateral acute angle closure in a pseudophakic patient’

Anterior-segment imaging for assessment of glaucoma

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