Posters

Acute angle closure caused by in-the-bag capsular tension ring and intraocular lens complex in a patient with pseudoexfoliation glaucoma

Poster Details

First Author: T.Kawaji JAPAN

Co Author(s): T. Sato                    

Abstract Details

Purpose:

A subluxation or dislocation of the intraocular lens (IOL) is a well-known complication after cataract surgery in patients with pseudoexfoliation syndrome and glaucoma. Capsular tension rings (CTR) are frequently used to prevent postoperative complications caused by zonular weakness. Here we present a case of an acute angle closure caused by in-the-bag CTR and IOL complex in a patient with pseudoexfoliation glaucoma.

Setting:

The patient underwent diagnostic and therapeutic procedures in Sato Eye & Internal Medicine Clinic in Japan.

Methods:

We describe the clinical course with elevated intraocular pressure (IOP) and shallowing of the anterior chamber (AC) in a patient, who is a 74-year-old man had cataract surgery with implantation of a CTR and suture-trabeculotomy 5 years ago, with secondary acute angle closure.

Results:

IOP elevation with open angle gradually occurred and underwent micropulse transscleral cyclophotocoagulation. At 10 days after surgery, the patient was referred with a hyphema with normal AC depth and high IOP (41mmHg), and then AC wash was done without complications. Next day, the examination showed a very shallow AC and still high IOP (46mmHg). The optical coherence tomography examination showed a peripheral iris pushed anteriorly by the CTR-IOL-capsular bag-complex, causing a 360 degrees angle closure. Next day, vitrectomy and ahmed glaucoma valve were performed. Nine months after the intervention, IOP remained controlled with normal AC depth.

Conclusions:

We present an unique type of secondary angle closure caused by an anterior dislocated capsular bag-CTR-IOL complex after the AC wash, although the cause of hyphema after micropulse transscleral cyclophotocoagulation was still unknown. Further follow-up is needed because the possibility of recurrence may be existed.

Financial Disclosure:

None