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Pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection
T L Jackson1, M Thiagarajan, R Murthy
1Rayne Institute, Academic Department of Ophthalmology, St Thomas' Hospital, Lambeth Palace Rd., London, SE1 7EH United Kingdom. TimLJackson@hotmail.com
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.