DR. HARSHITHA GOGINENI

DR.M MALLESWARI S

Abstract

A 60 year old female patient who has underwent RE cataract surgery with retro pupillary iris claw IOL implantation 4 years back, has presented with shallow peripheral anterior chamber depth and IOP of 50 mmhg.

The diagnosis of Secondary Angle Closure -Glaucoma due to pupillary block caused by the iris claw IOL was made.

Patient was treated with oral glycerol, oral acetazolamide, topical IOP lowering medications and Nd YAG peripheral iridotomy was made.

At 5 day follow up PI was patent, peripheral anterior chamber depth was normal and IOP was 14mmhg with topical Anti glaucoma medications, dilated fundus examination showed CDR of 0.7:1, with superior NRR loss.

There fore surgeon must create peripheral iridectomy to prevent pupillary block angle-closure glaucoma when ever Plano-convex or biconvex designs of Iris claw IOLs are used.

Convex–concave design has a better safety profile, and a peripheral iridectomy is not required with this design