Michael V McCaughey1, Thomas Mifflin2, Carlton R Fenzl2, Jason Goldsmith2, Majid Moshirfar3. 1. University of New Mexico School of Medicine, Albuquerque, USA. 2. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. 3. Francis I. Proctor Foundation, University of California San Francisco, San Francisco, USA.
Abstract
PURPOSE: To report a case of bilateral glaucoma related to pseudophacomorphic mechanism in one eye and pupillary block in the other eye after Visian Implantable Collamer Lens (ICL, STAAR Surgical) insertion. METHODS: A 44 year-old female with high myopia underwent bilateral ICL implantation of MICL12.6 after sulcus diameter measurements were performed by Pentacam. RESULTS: Pseudophacomorphic glaucoma-related angle closure occurred due to lens oversizing in the right eye. The mechanism was relieved via ICL explantation. In the left eye, pupillary block developed in a subacute manner after closure of the peripheral iridotomy (PI). The attack was ameliorated by reestablishing patency of the iridotomy. CONCLUSIONS: ICL-related glaucomatous attacks may result from improper sizing as well as from placement of a single PI. Identification of the proper mechanism is vital as treatments differ significantly. In pseudophacomorphic glaucoma, explantation is needed. In pupillary block glaucoma, treatment involves establishment of a patent PI.
PURPOSE: To report a case of bilateral glaucoma related to pseudophacomorphic mechanism in one eye and pupillary block in the other eye after Visian Implantable Collamer Lens (ICL, STAAR Surgical) insertion. METHODS: A 44 year-old female with high myopia underwent bilateral ICL implantation of MICL12.6 after sulcus diameter measurements were performed by Pentacam. RESULTS: Pseudophacomorphic glaucoma-related angle closure occurred due to lens oversizing in the right eye. The mechanism was relieved via ICL explantation. In the left eye, pupillary block developed in a subacute manner after closure of the peripheral iridotomy (PI). The attack was ameliorated by reestablishing patency of the iridotomy. CONCLUSIONS: ICL-related glaucomatous attacks may result from improper sizing as well as from placement of a single PI. Identification of the proper mechanism is vital as treatments differ significantly. In pseudophacomorphic glaucoma, explantation is needed. In pupillary block glaucoma, treatment involves establishment of a patent PI.
Authors: David Huang; Steven C Schallhorn; Alan Sugar; Ayad A Farjo; Parag A Majmudar; William B Trattler; David J Tanzer Journal: Ophthalmology Date: 2009-11 Impact factor: 12.079