Urrets-Zavalia Syndrome Following Cataract Surgery

Kurtz, Shimon; Fradkin, Maayan

doi:10.1159/000513959

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…One of the presumed risk factors is intraocular inflammation, such as toxic anterior segment syndrome or cataract remnants, which can lead to the release of inflammatory substances. 8 However, our patient presented with a minimal inflammatory reaction after surgery that responded appropriately to topical steroids, and no remnants of lens material were noted on intraoperative or postoperative examination.…”

Section: Discussionmentioning

confidence: 62%

Urrets–Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification

Cheng,

Vedula,

Kubal

et al. 2024

Journal of Current Glaucoma Practice

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Aim and background Combined endocyclophotocoagulation and phacoemulsification (ECP/Phaco) are uncommonly associated with complications. We present the first case of a rare complication following ECP/Phaco. Case description A 72-year-old patient with dense nuclear sclerotic cataracts and primary open-angle glaucoma (POAG) underwent bilateral surgery uneventfully. He experienced a brief episode of postoperative elevated intraocular pressure (IOP), but only one eye with a lower baseline IOP developed a dilated pupil. No pupillary response was observed after applying 4% pilocarpine. The fixed mydriasis persisted without reaction to light or near stimulus, and the best-corrected vision (BCVA) was 20/30 in the affected eye. Conclusion This case reports a possible rare complication when undergoing ECP/Phaco therapy. The pathogenesis of Urrets–Zavalia syndrome is unknown, but we hypothesized that eyes with more pronounced increases in IOP from baseline may be more susceptible to ischemic injury to the pupillary sphincter, resulting in a chronically dilated pupil. Clinical significance Even a modest transient rise in postoperative IOP in a glaucomatous eye with normal baseline IOP could result in a chronically dilated pupil. How to cite this article Cheng AMS, Vedula GG, Kubal AA, et al. Urrets–Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification. J Curr Glaucoma Pract 2024;18(1):28–30.

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Section: Discussionmentioning

confidence: 62%

Urrets–Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification

Cheng,

Vedula,

Kubal

et al. 2024

Journal of Current Glaucoma Practice

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“…In human literature, the clinical signs of UZS have been reported to appear between 1 and 21 days after the surgery ( Totuk et al , 2018 ; Kurtz and Fradkin, 2021 ). The exact time for the clinical signs to appear in the present study is unknown, as our first post-phacoemulsification recheck was performed 7 days after the surgery in all the cases.…”

Section: Discussionmentioning

confidence: 99%

Urrets-Zavalia syndrome following cataract surgery in dogs: A case series

Cantero¹,

Leiva²,

Gaztelu³

et al. 2022

Open Vet J

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Background: In human medicine, Urrets-Zavalia syndrome (UZS) is a well-recognized but uncommon postoperative complication characterized by a fixed dilated pupil, accompanied by iris atrophy and glaucoma. Although it was originally reported in 1963 after penetrating keratoplasty surgery for keratoconus, it has been associated with various ophthalmic procedures such as cataract surgery. The condition has not been previously published in the veterinary literature. Case Description: Three client-owned diabetic dogs that developed UZS´s triad after cataract surgery are described. Despite uneventful phacoemulsification in the six eyes, five developed moderate-to-severe postoperative ocular hypertension. Although intraocular pressure (IOP) spikes were initially controlled, fixed dilated pupils accompanied by iris atrophy and chronic ocular hypertension were seen in the five affected eyes. Aggressive medical and surgical management maintained vision in three of those eyes. In one eye, uncontrolled IOP led to blindness. Conclusion: This is the first published description of UZS in dogs, occurring after phacoemulsification. Although no exact, demonstrable causative element could be determined, we believe that should be considered a triggering condition for this syndrome, as it directly affects the ocular blood flow autoregulation and intrinsic uveal tissue integrity. Until the contrary is proved, diabetes mellitus might be considered as a risk factor for developing this syndrome after cataract surgery in dogs.

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Urrets-Zavalia Syndrome Following Cataract Surgery

Cited by 2 publications

References 12 publications

Urrets–Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification

Urrets–Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification

Urrets-Zavalia syndrome following cataract surgery in dogs: A case series

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