UBM Findings Of Pupillary Block Glaucoma Secondary To Viscoelastic Remnants In The Posterior Chamber After Anterior Chamber Phakic IOL Implantation

Chuan-bin Sun¹, Zhe Liu², Ke Yao¹

¹Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University Hangzhou, China.
²Eye Center, Zhejiang Provincial People's Hospital, Hangzhou, China.

Purpose: To report the clinical characteristics and UBM findings of pupillary block glaucoma secondary to viscoelastic remnants in the posterior chamber after anterior chamber phakic intraocular lens implantation despite a preexisting potent-appearing iridectomy.

Method: We present an interventional case report of acute angle-closure glaucoma which occurred soon after an uneventful implantation of an angle-supported phakic intraocular lens (pIOL) accompanied by an intraoperative full-thickness iridectomy in the right eye of a 25-year woman with axial high myopia.

Results: The initial slit lamp examination revealed anterior chamber disappearance except for a slight space between the central corneal endothelium and the pIOL optic, tight contact between the iris and pIOL, and a moderate-sized iridectomy at 12 o'clock accompanied by an increased IOP of 45 mm Hg. UBM showed the anterior chamber was extremely shallow and the iris, pIOL, and peripheral cornea were in close contact; the iridectomy was full thickness and of moderate size; the hyporeflective space in the posterior chamber was enlarged, accompanied by pools of fluid and a long distance between the pupil plane and the anterior surface of the crystalline lens; there was no evident ciliary body-lens contact. Two hours after a neodymium:YAG laser midperipheral iridotomy, the anterior chamber deepened to normal and the IOP decreased to 20 mm Hg.

Conclusions: We firstly report UBM findings of pupillary block glaucoma secondary to viscoelastic remnants in the posterior chamber after phakic intraocular lens implantation.