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. 2014 Nov;4(4):107-111.
doi: 10.4236/ojoph.2014.44017.

Pseudophacomorphic Glaucoma along with Pupillary Block after Visian™ Implantable Collamer Lens Implantation for High Myopia

Michael V McCaughey  1 , Thomas Mifflin  2 , Carlton R Fenzl  2 , Jason Goldsmith  2 , Majid Moshirfar  3
Affiliations

Pseudophacomorphic Glaucoma along with Pupillary Block after Visian™ Implantable Collamer Lens Implantation for High Myopia

Michael V McCaughey et al. Open J Ophthalmol. 2014 Nov.

Abstract

Purpose: To report a case of bilateral glaucoma related to pseudophacomorphic mechanism in one eye and pupillary block in the other eye after Visian Implantable Collamer Lens (ICL, STAAR Surgical) insertion.

Methods: A 44 year-old female with high myopia underwent bilateral ICL implantation of MICL12.6 after sulcus diameter measurements were performed by Pentacam.

Results: Pseudophacomorphic glaucoma-related angle closure occurred due to lens oversizing in the right eye. The mechanism was relieved via ICL explantation. In the left eye, pupillary block developed in a subacute manner after closure of the peripheral iridotomy (PI). The attack was ameliorated by reestablishing patency of the iridotomy.

Conclusions: ICL-related glaucomatous attacks may result from improper sizing as well as from placement of a single PI. Identification of the proper mechanism is vital as treatments differ significantly. In pseudophacomorphic glaucoma, explantation is needed. In pupillary block glaucoma, treatment involves establishment of a patent PI.

Keywords: Glaucoma; Pseudophacomorphic; Pupillary Block; Visian ICL.

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Figures

Figure 1
Figure 1
A slit-lamp photograph showing a patient PI (A), temporal corneal edema (B) , traumatic mydriasis, and iris atrophy (C)
Figure 2
Figure 2
A slit-lamp photograph showing a large sectoral surgical iridectomy exposing the edge of the Visian ICL (white arrow)
See this image and copyright information in PMC

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