Anterior Capsule Adherence to Iris Leading to Pseudophakic Pupillary Block

Naveh, Nava; Y, Wysenbeek; Solomon, Arie S; Melamed, Shlomo; Blumenthal, Michael

doi:10.3928/1542-8877-19910601-12

Ophthalmic Surg Lasers Imaging

1991

DOI: 10.3928/1542-8877-19910601-12

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Anterior Capsule Adherence to Iris Leading to Pseudophakic Pupillary Block

Nava Naveh¹,

Wysenbeek Y²,

Arie S Solomon³

et al.

Abstract: We present a rare case of anterior capsule adherence to the iris following extracapsular cataract extraction with posterior chamber intraocular lens implantation and leading to Pseudophakie pupillary block. There were no synechiae at the pupillary margins associated with the capsule/iris adherence, but aqueous was entrapped behind the iris and intraocular pressure rose. Laser iridotomy was temporarily beneficial, but it had to be repeated several times.

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Cited by 3 publications

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Pupillary block following posterior chamber intraocular lens implantation in adults

Gaton

Mimouni²,

Lusky³

et al. 2003

British Journal of Ophthalmology

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Background: Pupillary block rarely occurs after cataract extraction with posterior chamber intraocular lens implantation. Methods: A series of six patients (seven eyes) treated for pupillary block after posterior chamber intraocular lens implantation between 1990 and 2001 is described; in one eye, the attack occurred after phacoemulsification. Results: The interval between pupillary block development and the cataract surgery ranged from 1 day to 5 years. In all eyes, treatment consisted of neodymium-YAG laser peripheral iridotomy. In four eyes, the laser peripheral iridotomy relieved the block (one procedure in two; two to three procedures in two). One patient was also treated with YAG capsulotomy, and two patients needed additional surgical intervention. Conclusion: Despite the rarity of the complication of pupillary block after posterior chamber intraocular lens implantation, physicians should be aware of the sometimes difficult course of recovery after treatment.

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Pupillary block following posterior chamber intraocular lens implantation in adults

Gaton

Mimouni²,

Lusky³

et al. 2003

British Journal of Ophthalmology

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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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Pseudophakic pupillary block glaucoma in early postoperative period masquerading as endophthalmitis: Clinical features are important for differential diagnosis

Roy

2018

Oman J Ophthalmol

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Anterior Capsule Adherence to Iris Leading to Pseudophakic Pupillary Block

Cited by 3 publications

References 8 publications

Pupillary block following posterior chamber intraocular lens implantation in adults

Pupillary block following posterior chamber intraocular lens implantation in adults

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

Pseudophakic pupillary block glaucoma in early postoperative period masquerading as endophthalmitis: Clinical features are important for differential diagnosis

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