Pseudophakic Pupillary Block after Toxic Anterior Segment Syndrome

Chan Hong Min; Junki Kwon

doi:10.3341/jkos.2019.60.8.797

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Min and Kwon: Pseudophakic Pupillary Block after Toxic Anterior Segment Syndrome

Case Report

Journal of the Korean Ophthalmological Society 2019; 60(8): 797-801.

Published online: 20 August 2019

DOI: https://doi.org/10.3341/jkos.2019.60.8.797

Pseudophakic Pupillary Block after Toxic Anterior Segment Syndrome

Chan Hong Min, MD, Junki Kwon, MD

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address reprint requests to Junki Kwon, MD. Department of Ophthalmology, Asan Medical Center, #88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: 82-2-3010-1775, Fax: 82-2-470-6440, jkwon0620@naver.com

Received 27 December 2018 Revised 14 January 2019 Accepted 17 July 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of pseudophakic pupillary block after toxic anterior segment syndrome (TASS).

Case summary

An 84-year-old woman underwent phacoemulsification and intraocular lens implantation in the posterior chamber. Six days after surgery, anterior chamber inflammation was seen. Twenty-five days after surgery, a sudden increase in intraocular pressure (IOP) associated with pupillary block was observed. Despite the use of IOP-lowering medication, the IOP was not controlled. Peripheral laser iridotomy failed. After surgical peripheral iridectomy, IOP decreased significantly and was controlled.

Conclusions

Despite the rarity of TASS combined with pseudophakic pupillary block, clinicians must be aware of this condition in patients showing prolonged inflammatory state and IOP elevation after surgery.

Keywords: Iridectomy, Pseudophakia, Toxic anterior segment syndrome

Figures and Tables

Figure 1

Slit-lamp anterior segment photographs after cataract surgery, which were taken at local clinic (left: 1 week, right: 10 days). The images show 2+ grade of inflammatory cells and fibrous membrane in the anterior chamber.

Figure 2

Ultrasonographs of the left eye. The images show clear posterior segment.

Figure 3

Photographs of anterior segment optical coherence tomography before surgical iridectomy. The images show iris bowing with iridocorneal touch.

Figure 4

Slit-lamp anterior segment photographs ([A] before surgical iridectomy, [B] after surgical iridectomy). (A) The images show iris bowing and posterior synechiae before surgery. (B) The images show relieved iris bowing and deep anterior chamber.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

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