Pupillary block after pupillary capture of an AcrySof intraocular lens

A 54-year-old man developed pupillary block resulting from pupillary capture 2 months after uneventful phacomulsification and AcrySof intraocular lens (IOL) implantation. The IOL was placed in the bag through a 6.0 mm continuous curvilinear capsulorhexis. The glaucoma was treated with intravenous drip infusion of a hyperosmotic diuretic, followed by peripheral iridectomy, iridocapsular synechiolysis, and IOL repositioning. The IOL loops were located completely in the bag. However, pupillary capture recurred 3 weeks after the surgery, at which time intraocular pressure was normal. The flexibility of the IOL optic and its large overall length and rigid, low-angulated loops were the probable causes for the recurrence of the pupillary capture. The IOL was exchanged for a sulcus-fixated, single-piece poly(methylmethacrylate) lens with 10 degree angulated loops. Pupillary capture did not recur during the follow-up.