Seasonal variation in the incidence of malignant glaucoma after cataract surgery

Abstract

Purpose: To investigate a potential link between the incidence of malignant glaucoma after cataract surgery and seasonal variations in daylight. Methods: In total, 18,374 uncomplicated cataract surgeries were performed between June 2008 and June 2013 at an ambulatory surgery center in Toronto. Toronto's average monthly daylight over that time period—in hours per day for each month—was determined. The number of malignant glaucoma cases that developed after cataract surgery performed in months with above average daylight was compared to the number of cases that developed after cataract surgery performed in months with below average daylight. Fisher's exact test was used to analyze the relationship between the development of malignant glaucoma and variation in daylight during the month of cataract surgery. Results: Malignant glaucoma developed in 16 eyes. Thirteen cases of malignant glaucoma developed in months with above average daylight and three cases developed in months with below average daylight ( P = 0.01). Eyes that developed malignant glaucoma in months with more daylight were slightly longer (21.95 ± 1.23 mm) than those that developed malignant glaucoma in months with less daylight (21.55 ± 0.88 mm). Conclusion: Light-induced choroidal expansion may play a major role in the development of malignant glaucoma following cataract surgery.

Pseudophakic Pupillary Block due to the Capsular Bag Intraocular Lens Implant Located in the Sulcus: A Case Report

“…Absolute irido-lenticular block was ruled out through clinical examination and observation of freely mobile, the absence of iris bombe, and the absence of a secluded pupil. The previous literature estimates that the prevalence of aqueous misdirection after anterior segment surgery is between 0.6% and 4%, with the highest incidence in patients treated for angle closure [ 9 ]. Given our patient’s history of peripheral anterior chamber shallowing in the presence of patent LPIs after cataract surgery, the possibility of cilio-vitreo-lenticular block or aqueous misdirection was also considered and addressed by disrupting the posterior capsule with Nd:YAG capsulotomy; however, the patient continued to exhibit elevated IOPs.…”