A case of ciliocapsular block glaucoma following trabeculotomy and implantation of acrylic soft intraocular lens Naoko Kishimoto 1 , Kunihiko Tsuboi 1 , Mayuko Tanabe 1 , Ai Takahashi 1 , Chieko Fukui 1 , Tamotsu Yasukura 1 , Kazuya Yamagishi 1 , Kahoko Fujimoto 2 1Div of Ophthalmol, Kansai Med Univ Kohri Branch Hosp 2Tenroku Fujimoto Ganka pp.409-413
Published Date 1999/3/15
DOI https://doi.org/10.11477/mf.1410906250
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A 75-year-old female presented with raised intraocular pressure (IOP) in spite of medications in her right eye. Pseudoexfoliation was present in both eyes. The right eye showed plateau iris and was diagnosed as angle-closure glaucoma. The right eye was treated by uneventful surgery with implantation of acrylic soft intraocular lens (TOL) and trabeculotomy. On day 13 of surgery, the right eye showed very shallow anterior chamber with TOP at 36 mmHg. The condition was diagnosed as malignant glaucoma secondary to ciliocapsular block. Transpupillary YAG laser capsulotomy and anterior hyaloidotomy was ineffective due to adhesion of IOL to the lens capsule. Another 18 days later, we performed YAG laser photodisruption of the lens capsule and anterior hyaloid through the peripheral iridotomy opening. The anterior chamber became deep, the chamber angle became wide and the IOP decreased to 12 mmHg without medication. This case illustrates the necessity to perform peripheral iridectomy to facilitate eventual YAG laser application when planning implantation of acryl soft TOP in an eye prone to develop malignant glaucoma.

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