DR. MANSI JOHRI

DR. SWATI SINGH, DR. BHARAT RATNA THOUMUNGKAN

Abstract

Intracameral air injection at the end of cataract surgery is used frequently by surgeons for descemetopexy and to maintain AC volume and prevent wound leakage. But air in anterior chamber is known to cause IOP elevation which can mimic acute congestive glaucoma after cataract surgery and DSAEK. We describe two cases of mature cataract who presented with acute IOP elevation and severe systemic symptoms on first postoperative day, caused by air injection at the end of uncomplicated phacoemulsification surgery with air having moved behind the iris causing angle closure by posterior pushing mechanism and irido-corneal contact. Both patients were managed medically with systemic hyperosmotics and topical cycloplegic -mydriatic therapy and supine positioning. IOP spikes are seen after uncomplicated cataract surgery because of tight wound, inflammation, retained viscoelastic and cortical matter but large air bubble behind the iris can create a medical emergency which must be managed promptly.