Pupillary and iridovitreal block in pseudophakic eyes

Twenty-six cases of pupillary and iridovitreal block in pseudophakic eyes are reported. Although ten patients presented with acute angle closure glaucoma, the majority were asymptomatic and had normal intraocular pressures. While cure was finally achieved in all cases, recurrence of block occurred in six eyes as late as two months after initial successful treatment. A variety of therapeutic modalities including argon laser iridectomy, argon laser gonioplasty (iridoplasty), surgical iridectomy, surgical vitrectomy, Q-switched Nd:YAG laser iridectomy and Nd:YAG laser photodisruption of the anterior vitreous face were needed. Despite successful relief of pupillary and iridovitreal block in these eyes with no evidence of glaucoma prior to cataract and lens implant surgery, four eyes developed eight or more clock hours of peripheral anterior synechiae, and nine eyes continue to require chronic medical therapy for glaucoma.