A Case of Acute Angle Closure Secondary to Pupillary Block Caused by a Dislocated Intraocular Lens-Capsular Tension Ring Complex

Abstract

We report a case of acute angle closure secondary to pupillary block caused by a dislocated intraocular lens (IOL)-capsular tension ring (CTR) complex. A 68-year-old woman, who had undergone cataract surgery 28 months earlier, presented with acute right eye pain and blurred vision. Examination revealed elevated intraocular pressure (IOP) of 80 mmHg, corneal edema, and anterior chamber shallowing, with anterior displacement of the IOL-CTR complex observed on anterior-segment optical coherence tomography. An anterior chamber paracentesis and subsequent vitrectomy were performed to remove the dislocated complex. After scleral fixation of a new IOL and management of an epiretinal membrane, the patient’s vision improved, with her best-corrected visual acuity reaching 1.2 and IOP stabilizing at 18 mmHg without medication. This case highlights the potential for IOL-CTR dislocation to cause pupillary block and acute angle closure, emphasizing the need for timely diagnosis and comprehensive surgical intervention to preserve visual function.