Cases reported "Glaucoma, Angle-Closure"

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1/9. Primary phacoemulsification for uncontrolled angle-closure glaucoma.

    PURPOSE: To report the results of primary phacoemulsification to treat uncontrolled angle-closure glaucoma. SETTING: private practice and teaching hospital department. methods: This retrospective interventional case series assessed 3 patients having phacoemulsification and posterior chamber intraocular lens implantation for uncontrolled intraocular pressure (IOP) after acute primary angle-closure glaucoma. RESULTS: intraocular pressure control was achieved in all patients postoperatively. CONCLUSIONS: Primary phacoemulsification with the option of future trabeculectomy should be considered in selected patients with persistent appositional angle closure and uncontrolled IOP after angle-closure glaucoma.
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keywords = phacoemulsification
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2/9. 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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ranking = 0.14285714285714
keywords = phacoemulsification
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3/9. 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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ranking = 0.14285714285714
keywords = phacoemulsification
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4/9. Lensectomy in the management of glaucoma in spherophakia.

    A 42-year-old woman presented with uncontrolled glaucoma despite patent peripheral iridotomies after a previous episode of acute angle-closure glaucoma. Spherophakia was diagnosed by anterior segment findings, refraction, A-scan biometry, and ultrasound biomicroscopy. Continuous curvilinear capsulorhexis, phacoemulsification, and infusion/aspiration were performed in the right eye. Attempted intraocular lens (IOL) implantation failed, and the eye was left aphakic. Six months later, the intraocular pressure (IOP) was normal without glaucoma therapy and visual acuity was 6/6 with a contact lens. The patient then had phacoemulsification in the left eye, removal of the capsular bag, anterior vitrectomy, and insertion of an anterior chamber IOL. Four months after surgery, the uncorrected visual acuity was 6/9 and the IOP was normal without glaucoma therapy.
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ranking = 0.28571428571429
keywords = phacoemulsification
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5/9. 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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ranking = 0.71428571428571
keywords = phacoemulsification
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6/9. Unusual presentation of angle-closure glaucoma treated by phacoemulsification.

    We report the case of a 70-year-old woman with a history of acute primary angle-closure glaucoma (PACG) in the left eye who, 2 hours after a fundus examination and mydriasis, experienced acutely elevated intraocular pressure (IOP) up to 40 mm Hg in the presence of fully dilated pupil and a patent iridotomy. gonioscopy revealed appositional angle closure in 3 quadrants. After medical control of the IOP, sutureless cataract surgery was performed, including clear corneal incision, phacoemulsification, and soft acrylic posterior chamber intraocular lens (IOL) implantation. Eighteen months after the operation, improvement of visual acuity, widening of anterior chamber angle, and deepening of anterior chamber depth were found. Intraocular pressures are now normal without medication, even after mydriasis. Modern cataract surgery is an effective treatment for selected patients with appositional angle closure and IOP elevation after acute PACG.
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ranking = 0.71428571428571
keywords = phacoemulsification
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7/9. vitrectomy-phacoemulsification-vitrectomy for the management of aqueous misdirection syndromes in phakic eyes.

    OBJECTIVE: To describe vitrectomy-phacoemulsification-vitrectomy, a sequential 3-step surgical approach, in the management of malignant glaucoma/aqueous misdirection syndromes in phakic eyes. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Five eyes (4 angle-closure glaucoma and 1 open-angle glaucoma) of 5 patients with mean age of 66 years (range, 56-78). Four patients presented with aqueous misdirection syndrome and 1 patient presented for cataract extraction, having previously had malignant glaucoma in the fellow eye after phacoemulsification surgery. INTERVENTION: The operation performed had three steps: vitrectomy, phacoemulsification, and vitrectomy. Step 1: Preliminary vitrectomy involved limited core vitrectomy to "debulk" the vitreous and soften the eye. Step 2: phacoemulsification was performed in a standard manner. Step 3: Residual vitrectomy, zonulohyaloidectomy and peripheral iridectomy (if not already present) were performed to create a free communication between the posterior and anterior segments. MAIN OUTCOME MEASURES: intraocular pressure, visual acuity, biomicroscopic anterior chamber depth, and complications. RESULTS: The time interval between the onset of malignant glaucoma and surgery ranged from 2 weeks to 3 months. All 4 patients with aqueous misdirection syndrome had relief of the aqueous misdirection postoperatively with anterior chamber deepening. Intraocular pressures on day 1 ranged from 6 to 28 mmHg (mean 15.6, mmHg), and at the last visit ranged from 8 to 30 mmHg (mean, 20.4 mmHg). One eye developed an early choroidal serosanguinous effusion requiring drainage. CONCLUSIONS: The vitrectomy-phacoemulsification-vitrectomy approach was effective in this pilot series in the management of aqueous misdirection syndromes and malignant glaucoma in phakic eyes.
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ranking = 1.1428571428571
keywords = phacoemulsification
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8/9. phacoemulsification using iris-hooks for capsular support in high myopic patient with subluxated lens and secondary angle closure glaucoma.

    We report an unusual case of angle closure glaucoma in a 78-year-old highly myopic female patient. The patient did not show any preoperative signs of subluxation of lens. However, the capsular bag was noted to be unstable during surgery. The patient was managed with phacoemulsification of lens using a novel method of iris hooks for stabilization of capsular bag during surgery.
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ranking = 0.14285714285714
keywords = phacoemulsification
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9/9. Clinical findings in Brown-McLean syndrome.

    The Brown-McLean syndrome is a clinical condition with corneal edema involving the peripheral 2 to 3 mm of the cornea. The edema typically starts inferiorly and progresses circumferentially, but spares the central portion of the cornea. Additionally, the edema is associated with a punctate orange-brown pigmentation on the endothelium underlying the edematous areas. Central cornea guttata is frequently seen. This condition occurs most frequently after intracapsular cataract extraction, but may also occur after extracapsular cataract extraction and phacoemulsification, or pars plana lensectomy and vitrectomy. Surgical complications and multiple intraocular procedures are frequently observed in these patients. Less frequently, the Brown-McLean syndrome can occur in eyes that have not had surgery. We studied the clinical characteristics of 43 affected eyes of 32 patients. New findings included Brown-McLean syndrome occurring in two eyes of a phakic patient with intermittent angle-closure glaucoma. Two eyes developed Brown-McLean syndrome after phacoemulsification and one eye developed peripheral edema after pars plana vitrectomy and lensectomy. Additionally, severe, infectious keratitis occurred after rupture of peripheral bullae in two eyes. patients with this condition should be examined periodically and educated regarding the early clinical signs of corneal ulceration.
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ranking = 0.28571428571429
keywords = phacoemulsification
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