Cases reported "Glaucoma, Angle-Closure"

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1/38. Suspected ciliary block associated with Viscoat use.

    Ciliary block or malignant glaucoma is thought to be caused by the misdirection of aqueous into the vitreous. It is refractory to medical treatment and often requires vitreous aspiration. We present a case of ciliary block glaucoma caused by sodium chondroitin sulfate-sodium hyaluronate (Viscoat) gaining access to the vitreous through an unsuspected, small zonular dialysis. vitrectomy performed through a peripheral iridectomy resolved this severe condition.
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2/38. role of ultrasound biomicroscopy in managing pseudophakic pupillary block glaucoma.

    We describe a case of anterior capsule adherence to the iris that occurred after phacoemulsification with in-the-bag intraocular lens (IOL) implantation. This adherence led to the development of pseudophakic pupillary block glaucoma. There were no synechias at the pupillary margin associated with the capsule-iris adherence. Ultrasound biomicroscopy, used to evaluate the anterior segment in vivo, clarified the mechanism of pseudophakic pupillary block. The pupillary block was relieved by a single laser iridotomy.
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3/38. Vitreous opacities affect scanning laser polarimetry measurements.

    PURPOSE: To assess the effect of vitreous opacities on retinal nerve fiber layer retardation measurements obtained during scanning laser polarimetry. methods: scanning laser polarimetry was performed in two eyes of two patients with vitreous opacities. RESULTS: The presence of a vitreous opacity within the measurement ellipse during scanning caused a marked, localized increase in polarization in the area of the opacity. This falsely increased the value obtained for the mean retinal nerve fiber layer thickness. Retinal nerve fiber layer thickness values were reduced when the opacity was not incorporated into the measurement ellipse. CONCLUSION: Artifact introduced by the presence of vitreous opacities can affect scanning laser polarimetry measurement reliability.
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4/38. pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection.

    PURPOSE: To describe pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection. DESIGN: Interventional case series. methods: Cases were collected from January 1997 to July 2000 from three tertiary referral centers. RESULTS: Seven phakic patients (seven eyes) and one pseudophakic patient (one eye) presented 1 to 90 days after vitrectomy and silicone oil injection with intraocular pressures of 36 to 70 mm Hg. Five patients had an observed or potential weakness of the iris-lens diaphragm. Treatment with Nd:YAG-laser peripheral iridotomy or inferior iridectomy provided a temporary reduction in intraocular pressure for some patients, but all eventually required removal of silicone oil. CONCLUSION: pupil block glaucoma after silicone oil injection is well recognized in aphakic patients, but ophthalmologists should be aware that it can occur in phakic and pseudophakic patients, particularly in complicated cases and patients with a weakness of the iris-lens diaphragm.
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5/38. Capsular block syndrome associated with secondary angle-closure glaucoma.

    An 83-year-old man who had phacoemulsification and ciliary sulcus fixation of a posterior chamber intraocular lens developed capsular block syndrome with secondary glaucoma 1 year after surgery. The glaucoma resolved, and vision returned immediately after a neodymium:YAG laser capsulotomy was performed. Capsular block syndrome with secondary angle-closure glaucoma should be considered in pseudophakic patients presenting with increased intraocular pressure and a narrow angle.
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6/38. Pupillary block after phakic anterior chamber intraocular lens implantation.

    A 49-year-old patient developed pupillary block glaucoma with an intraocular pressure (IOP) of 29 mm hg after implantation of a phakic intraocular lens (IOL) (NuVita, Bausch & Lomb) in the left eye. the anterior chamber deepened again, and the iop decreased to 16 mm hg after a neodymium: YAG iridotomy. Pupillary block glaucoma may occur after phakic IOL implantation without iridotomy, and we advocate that routine iridotomy be performed during phakic IOL surgeries.
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7/38. Pupillary block glaucoma following implantation of a posterior chamber pseudophakos in the anterior chamber.

    Pupillary block glaucoma is a common complication of cataract surgery, especially following anterior chamber intraocular lens implantation. We report a case of pupillary block glaucoma with a posterior chamber IOL that was implanted in the anterior chamber following a complicated extracapsular cataract extraction. The case was successfully managed by explantation of the posterior chamber lens, anterior vitrectomy, peripheral iridectomy and secondary anterior chamber intraocular lens implantation. The intraocular pressure was controlled with a single topical antiglaucoma medication.
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8/38. Pseudophakic pupillary block caused by pupillary capture after phacoemulsification and in-the-bag AcrySof lens implantation.

    We describe a 50-year-old patient who developed pupillary block caused by pupillary capture 1 week after uneventful phacoemulsification and implantation of an AcrySof foldable intraocular lens (IOL). The patient had a large but intact capsulorhexis with the haptics lying in the bag; the optic lay in the pupillary area anterior to the capsulorhexis. This case was successfully managed by a neodymium: YAG laser iridotomy, IOL explantation, and subsequent implantation of a poly(methyl methacrylate) posterior chamber IOL. To prevent this complication, we suggest the optic be larger than the capsulorhexis and advocate correct, gentle insertion of the foldable IOL.
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9/38. Angle closure glaucoma following pupillary block in an aphakic perfluoropropane gas-filled eye.

    We report the case of a 35-year-old aphakic patient who developed an intractable secondary glaucoma due to angle closure after pupillary block following the use of perfluoropropane (C3F8) gas at a nonexpansile concentration of 14%.
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10/38. Malignant glaucoma induced by a phakic posterior chamber intraocular lens for myopia.

    A 23-year-old woman with -14.00 diopters of myopia requested emmetropia for professional reasons. An ICM 130 V2 myopic phakic intraocular lens (IOL) (Staar Surgical AG) was implanted in the posterior chamber. Three days later, the patient developed malignant glaucoma. Pupillary block glaucoma and choroidal hemorrhage or effusion were ruled out. As maximum medical treatment failed, rapid secondary surgery was performed with sclerotomy, aspiration in the midvitreous cavity, and removal of the IOL. The follow-up was 43 months.
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