Posters

Urrets-Zavalia Syndrome following extra capsular cataract extraction

Poster Details

First Author: Y.Saoiabi MOROCCO

Co Author(s): R. El Hachimi   R. El Hadiri   S. Benchekroune   M. Bentaleb   A. Amazouzi   O. Cherkaoui     

Abstract Details

Purpose:

Describe a rare case of Urrets-Zavalia syndrom, following cataract surgery, and to raise awarness about this  exceptional underdiagnosed syndrom.

Setting:

Hôpital des spécialités RABAT

Methods:

Case report, of 62 yo female with rock-hard cataract OS, who developed unilateral UZS following the cataract surgery The patient presented with hard-rock cataract, with no ocular-trauma, systemic diseases or iris atrophy. The intraocular pressures (IOP), measured using an applanation tonometer, were OD 15 and OS 13 mmHg. Gonioscopy revealed moderate pigmentation on the trabecular meshwork and open angle The fundus examination was normal. The surgical procedure was an extra-capsular extraction, after dilated the pupil by mydriatics. An ophthalmic viscosurgical device (dispersive OVD) was used and injected into the anterior chamber. A Rigid, single-piece IOL was implanted in the sulcus.

Results:

The patient received post operative corticosteroids. In the first post operative day, intraocular pressure was 23 mmHg, and a fixed and dilated pupil was noted. the patient received acetazolamide, and the visual acuity was not tested. The IOP dropped 2 days after to 11 mmHg, remained dropped after we stopped the acetazolamide, and we noticed an iris atrophy with a mild anterior chambre cell reaction, and pigmentary dispersion. Two weeks after, the inflamation was reduced with corticosteroids, but without improvement of the visual acuity, that was reduced to hand motion. The IOP is still around 10 and 11 mmHg.

Conclusions:

Urrets-Zavalia is a rare syndrom that occurs mostly after PK. In our knowledge, this is the first case of UZS after an extra-capsular cataract extraction. UZS is still a clinical reality even if its incidence is low. This is a potential complication concerning all operated corneal transplant patients and other intraocular surgical procedures, whose treatment is essentially preventive and based in particular on the absence of prescription of postoperative mydriatic eye-drops(unless imperative), the removal as wide as possible of the viscous product present in the AC at the end of the intervention Ophtalmologists should be aware about this exceptionel complication.

Financial Disclosure:

None