scholarly journals Late Spontaneous Reabsorption of Interface Fluid after Descemet’s Stripping Automated Endothelial Keratoplasty Surgery

2020 ◽  
Vol 11 (2) ◽  
pp. 423-429
Author(s):  
Filippo Romanazzi ◽  
Anna Morano ◽  
Antonio Caccavale
Keyword(s):  
Anterior Segment ◽  
Corneal Stroma ◽  
Cataract Extraction ◽  
Acute Angle ◽  
Angle Closure ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Acute Angle Closure ◽  
Normal Thickness ◽  
The Right

An 80-year-old male was referred to our hospital for chronic bullous keratopathy in the right eye. Ten years before, he was affected by an attack of primary acute angle closure glaucoma in high hyperopia and Fuchs’ endothelial dystrophy. A bilateral iridotomy was performed. Thereafter, the patient developed an endothelial decompensation in the left eye, and, in another hospital, he underwent an open-sky combined cataract extraction and penetrating keratoplasty. Our surgical approach for the right eye consisted of phacoemulsification and, after 1 month, a Descemet’s stripping automated endothelial keratoplasty (DSAEK). After the procedure, an interface fluid was suspected, and an anterior segment optical coherence tomography (OCT) confirmed it. The graft was well centered but thickened, showing no movement in the anterior chamber, adherent to the periphery of the recipient cornea but with a pool of fluid in the center. Seven days postoperatively, an anterior segment OCT showed initial signs of reabsorption of the fluid. On day 45, the graft was adherent with normal thickness and the interface fluid had completely disappeared. The corneal stroma was clear, but a faint interface opacity appeared and is still present. We obtained a good surgical result and best corrected visual acuity was 7/10 at postoperative month 4. No further surgical procedures are scheduled.

scholarly journals A Rare Case of Unilateral Progressive Cataract in a Young Patient Receiving Topiramate

2020 ◽  
Vol 11 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Tanuja Kate ◽  
Rajiv Choudhary ◽  
Jyoti Singhai ◽  
Navita Pathak
Keyword(s):  
Young Patient ◽  
Past History ◽  
Anterior Segment ◽  
Acute Angle ◽  
Angle Closure ◽  
Rapid Progression ◽  
Topical Steroids ◽  
Acute Angle Closure ◽  
The Right

This case report presents an instance of unilateral cataract formation and its rapid progression following topiramate-induced bilateral acute angle closure. An 18-year-old female diagnosed with acute angle closure in both eyes had started treatment on the previous day at another healthcare facility. The patient presented with complaints of pain, sudden diminution of vision, excessive watering, and photophobia (both eyes) and reported the use of topiramate for headache for 10 days. There was no past history of decreased vision, trauma, uveitis, or use of steroids. Topiramate-induced bilateral secondary angle closure attack was the presumptive diagnosis. Topiramate use was stopped, and antiglaucoma drugs, topical cycloplegic, and topical steroids were started. On 1-day follow-up, clearer cornea and peripheral anterior capsular lenticular opacity of the right eye were observed. Gonioscopy showed closed angles. Anterior segment optical coherence tomography showed forward movement of the iris-lens diaphragm and closed angles. B-scan showed ciliochoroidal effusion in the right eye and normal left eye. At 2-month follow-up, formed anterior chamber and posterior subcapsular cataract in the right eye were seen. There were no lenticular changes in the left eye. Definite progression of cataract from day-1 to 2-month follow-up was seen in the right eye. To our knowledge, this is the first report of the rapid progression of cataract following topiramate-induced secondary angle closure in a young patient warranting surgical intervention.

scholarly journals Aphakic Pupillary Block by an Intact Anterior Vitreous Membrane after Total Lens Extraction by Phacoemulsification

2021 ◽  
pp. 882-888
Author(s):  
Michihiro Kono ◽  
Akiko Ishida ◽  
Sho Ichioka ◽  
Masato Matsuo ◽  
Hiroshi Shimizu ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Cataract Extraction ◽  
Japanese Woman ◽  
Acute Angle ◽  
Angle Closure ◽  
Pupillary Block ◽  
Lens Extraction ◽  
Old Japanese ◽  
Acute Angle Closure ◽  
Vitreous Prolapse

An 85-year-old Japanese woman with acute primary angle closure in her right eye underwent cataract extraction. Because of the weakness of the Zinn’s zonules, all of the lens tissue including the lens capsule was removed by phacoemulsification. Because of the absence of vitreous prolapse into the anterior chamber, vitrectomy was not performed. Nine days postoperatively, acute angle closure due to pupillary block by an anterior vitreous membrane developed. To resolve the pupillary block, anterior vitrectomy was performed on the same day. Postoperatively, her symptoms resolved, the anterior chamber deepened, and the intraocular pressure normalized. Although rare, acute angle closure due to pupillary block by an anterior vitreous membrane can occur after total lens extraction with phacoemulsification. If no vitreous prolapse occurs with total lens extraction, an intentional hyaloidotomy using an anterior vitreous cutter or iridectomy should be considered to avoid secondary angle closure.

scholarly journals Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

2019 ◽  
Author(s):  
Hong-Yang Zhang ◽  
Hong-Liang Lin ◽  
Yong-Jie Qin ◽  
Yu-Lin Zhang ◽  
Yu-Qiao Zhang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Clinical Characteristics ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Fellow Eye ◽  
Lens Extraction ◽  
Lens Subluxation ◽  
Acute Angle Closure

Abstract BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.

scholarly journals Bilateral Acute Angle-Closure Glaucoma: A Case Report of an Unusual Cause of Acute Headache in a Child

2021 ◽  
Vol 5 (4) ◽  
pp. 443-446
Author(s):  
Breelan Kear ◽  
Claudia Gold ◽  
Rahul Bhola
Keyword(s):  
Case Report ◽  
Anterior Segment ◽  
Acute Attack ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Ophthalmological Examination ◽  
Eye Pain ◽  
Acute Angle Closure ◽  
Acute Angle Closure Glaucoma

Introduction: Acute angle-closure glaucoma (AACG) is typically considered a disease of adulthood. However, AACG may occasionally be seen in children. The clinical presentation is similar to adults, including headache, vomiting, and eye pain. However, the etiology of angle closure in children is different and most often associated with congenital anterior segment abnormalities. A precipitating factor of AACG in children with previous established, anterior segment abnormalities is eye dilation, which may occur during routine ophthalmological examination with topical mydriasis, or physiologic mydriasis upon entering a dark room. Case Report: We describe a 5-year-old child with a history of severe prematurity and retinopathy of prematurity (ROP) presenting with bilateral AACG following a routine outpatient, dilated ophthalmological examination. While angle-closure glaucoma has previously been reported in cases of ROP, a bilateral acute attack of AACG following pupil dilation in regressed ROP has hitherto been unreported. Conclusion: Given the association of ROP and AACG, it can be expected that as the survival rate of premature infants improves, the incidence of ROP and AACG may also increase. It is therefore prudent for the emergency physician to have AACG on the differential for pediatric patients with headache and eye pain.

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