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Abstract #28114 Published in IGR 13-1
Bilateral explantation of Visian implantable collamer lenses secondary to bilateral acute angle closure resulting from a non-pupillary block mechanism
Khalifa YM; Goldsmith J; Moshirfar MJournal of Refractive Surgery 2010; 26: 991-994
PURPOSE: To report a case of bilateral non-pupillary block angle closure glaucoma after Visian Implantable Collamer Lens (ICL, STAAR Surgical) surgery. METHODS: A 35-year-old woman with high myopia, white-to-white measurements of 11.8 mm in the right eye and 11.9 mm in the left eye, and anterior chamber depths >3 mm in both eyes underwent simultaneous bilateral ICL implantation with 13.2-mm lenses. RESULTS: Persistent, bilateral acute angle closure developed despite multiple patent peripheral iridotomies and iridectomies. Visante anterior segment optical coherence tomography (AS-OCT, Carl Zeiss Meditec) revealed profound vaulting of the ICLs and angle closure. Both ICLs were explanted. After explantation, ultrasound biomicroscopy demonstrated a sulcus-to-sulcus diameter of 10.8 mm in the right eye and 11.2 mm in the left eye. CONCLUSIONS: The correlation between white-to-white and sulcus-to-sulcus measurements were poor in this patient, resulting in extreme vaulting of the ICL and angle closure from a non-pupillary block mechanism. Proper identification of the mechanism of angle closure is aided by AS-OCT. For non-pupillary block mechanisms, ICL extraction is necessary.
M. Moshirfar. John A. Moran Eye Center, University of Utah, Salt Lake City, UT, United States. majid.moshirfar@hsc.utah.edu
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)