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Abstract #53580 Published in IGR 15-2
Simple technique to abort pupillary block glaucoma secondary to anterior chamber crystalline lens dislocation in Marfan's syndrome
Bourkiza R; Elgohary M; Barton K; Sullivan PClinical and Experimental Ophthalmology 2013; 41: 898-899
A 64-year-old man with Marfan's syndrome was referred with ectopia lentis and visual acuity (VA) of 6/12 bilaterally. He had a history of right BRVO, aortic aneurysm stenting and multiple TIAs and was on warfarin and clopidogrel. He was listed for a right vitreolensectomy. Overnight, however, he had severe left eye pain and vomiting that gradually resolved. On examination, his VA was 6/60 and his pupil was mid-dilated. The cornea was oedematous (figure 1) but his intraocular pressure (IOP) was 14mmHg. He was given pilocarpine drops and listed for a left vitreolensectomy. However, he presented again with an IOP of 48mmHg and a pupil-captured crystalline lens (figure 2). His IOP was successfully controlled medically with intravenous Mannitol, acetazolamide and topical hypotensives, and an Nd-YAG iridotomy was arranged to prevent further episodes. However, upon corneal indentation during gonioscopy the lens relocated to the posterior chamber. The iridotomy was completed and the patient suffered no further acute angle closure episodes. He underwent vitreolensectomy and anterior chamber lens implantation in both eyes. Postoperatively, his best corrected VA was 6/6 and IOP was 18 mmHg.
Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, United Kingdom.
Full articleClassification:
9.4.4.3 Glaucomas associated with lens dislocation (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
