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Abstract #72862 Published in IGR 18-4

Goniosynechialysis and Repositioning of Intraocular Lens in a Case of Secondary Angle Closure Glaucoma

Fujita M; Ogata M; Suzuki Y; Ichihashi T; Nagahara M; Kawai K
Tokai Journal of Experimental and Clinical Medicine 2017; 42: 25-29


PURPOSE: Implanting intraocular lens (IOL) in proper direction is important in cataract surgery to reduce the possibility of undesirable complications. We experienced a case who underwent vitrectomy combined with cataract surgery and developed secondary angle closure glaucoma caused by IOL misdirection. Goniosynechialysis (GSL) and repositioning of IOL successfully ameliorated the high intraocular pressure (IOP). CASE REPORT: A 64-year-old male with massive vitreous hemorrhage underwent vitrectomy combined with cataract surgery. In implanting IOL, posterior capsule was accidentally raptured, and we were obliged to implant IOL reversely in the ciliary sulcus. A month postoperatively, the capture of IOL by iris and the shallow anterior chamber with iris bombe formation led to the elevated IOP up to 60 mmHg. Laser iridotomy and maximum anti-glaucoma medications including oral carbon anhydrase inhibitor could not control IOP. Subsequently, we performed GSL and IOL repositioning to correct the lens direction and the IOP was successfully reduced to normal level. CONCLUSION: Reversely sulcus-implanted IOL should be repositioned to prevent secondary angle closure glaucoma.

Department of Ophthalmology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan. fu6ji2ta1@yahoo.co.jp.


Classification:

9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)



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