Bilateral aqueous misdirection syndrome after routine cataract surgery in angle closure

Cataract surgery with intraocular lens (IOL) implantation is increasingly preferred over laser peripheral iridotomy as the first-line management of primary angle-closure glaucoma after endorsement by the recently reported EAGLE (Effectiveness of Early Lens Extraction for the Treatment of Primary Angle-Closure Glaucoma) study. However, we present 2 eyes of a 63-year old woman, both of which remained shallow after cataract surgery, with 1 eye developing high and uncontrolled intraocular pressure. Both eyes needed further intervention; the latter eye received surgical treatment as well.