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Pseudophakic pupillary block with angle-closure glaucoma in diabetic patients
American Journal of Ophthalmology
|September 15, 1986
Summary
Diabetic patients who had cataract surgery without a peripheral iridectomy developed severe glaucoma. Prompt treatment, including laser or surgical iridectomy, is crucial for managing this complication.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Cataract Surgery Complications
Background:
- Pseudophakic pupillary block with angle-closure glaucoma is a potential complication following cataract surgery.
- Peripheral iridectomy is a preventive measure often performed during cataract extraction.
Observation:
- Six diabetic patients (63-79 years old) developed this complication post-extracapsular cataract extraction.
- None had undergone a prophylactic peripheral iridectomy.
- Symptoms included ocular pain, visual loss, corneal edema, and markedly elevated intraocular pressure (up to 80 mm Hg).
Findings:
- Laser iridotomy was effective in reducing intraocular pressure in three out of four treated eyes.
- Surgical peripheral iridectomy was successful in a case where laser treatment was precluded by corneal edema.
- One eye with concurrent central retinal vein occlusion received panretinal photocoagulation and trabeculectomy.
Implications:
- This case series highlights the risk of pseudophakic pupillary block in diabetic patients undergoing extracapsular cataract extraction without peripheral iridectomy.
- It underscores the importance of prophylactic peripheral iridectomy in at-risk populations.
- Timely diagnosis and appropriate intervention, whether laser or surgical iridectomy, are vital for preserving vision.