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Pupillary block following the placement of an iris-claw IOL

Poster Details

First Author: C.Broquen ARGENTINA

Co Author(s):    F. Pellegrino   T. Jaeschke                 

Abstract Details

Purpose:

To present a case of pupillary block in a patient with an iris-claw phakic IOL, its urgent treatment, and the review of the literature on these cases.

Setting:

Hospital Oftalmol�Ã�³gico Dr. Pedro Lagleyze. Ciudad Aut�Ã�³noma de Buenos Aires. Argentina.

Methods:

A 36-year-old female patient refers pain and redness in her right eye (RE) associated with nausea 24 hours after the placement of an iris-claw IOL. Ophthalmological background: implantation of a phakic IOL in her left eye (LE) the previous month. Best corrected visual acuity: RE 20/200 LE 20/25. Biomicroscopy: RE: Narrow anterior chamber. Iris-claw lens. Non reactive intermediate mydriasis. Corneal edema. Mixed conjunctival injection. LE: Iris-claw lens. Intraocular pressure (IOP): RE 48mmHg LE 12mmHg. Oral acetazolamide 500 mg is indicated and peripheral iridotomy with YAG Laser is performed in the RE.

Results:

Two hours after the admission, the patient resolves with good visual acuity and no pain. IOP is 19 mmHg and visual acuity 20/25. Prior to the iridotomy and 24 hours post-procedure, a Pentacam�Â�® was performed, with corneal and anterior chamber thickness values supporting the clinical diagnosis of narrow-angle acute glaucoma and the favorable response to the indicated treatment.

Conclusions:

Pupillary block is one of the most frequent and severe complications after the placement of an iris-claw phakic IOL. Preventing this should be the main goal, either through intraoperative iridectomy or peripheral iridotomies with YAG laser two weeks prior to surgery. Furthermore, strict control of IOP in the early postoperatory period may contribute to the early diagnosis of pupillary block. In order to avoid the serious and irreversible complications of acute glaucoma and its implications on the optic nerve and corneal wellness.

Financial Disclosure:

NONE

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