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. 2020 Jun 2:14:1495-1501.
doi: 10.2147/OPTH.S255626. eCollection 2020.

Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy

Islam Taher Ragab  1 , Amr Mohammed Elsayed Abdelkader  1 , Hanem Mohammad Kishk  1 , Abdelmohsen Abdelghany Elshal  1
Affiliations

Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy

Islam Taher Ragab et al. Clin Ophthalmol. .

Abstract

Purpose: Pseudophakic glaucoma is a secondary glaucoma in which intra-ocular pressure is elevated following cataract removal. The current study aimed to evaluate the role of ultrasound biomicroscopy (UBM) in assessing post-operative pseudophakic glaucoma.

Patients and methods: This is a case series, prospective, observational and analytical study. It included 29 eyes of 29 patients with post-operative pseudophakic glaucoma. The patients were evaluated by medical history, detailed ophthalmologic examination and UBM.

Results: UBM examination has unmasked different causes of pseudophakic glaucoma. The detected causes were classified into 3 main groups, including intraocular lens (IOL)-related causes, lens remnants and intra-ocular inflammation. Haptic-related causes were present in 9 eyes, while 6 eyes had decentered or tilted IOLs. Soemmering's ring was the main cause in 3 eyes while in one eye the cause was lens particle in the anterior chamber (AC). Silicone oil in AC with seclusio pupillae was the main cause in one eye. Peripheral anterior synechiae were detected in 8 eyes while, posterior synechiae were evident in 7 eyes. Uveitis induced by anterior chamber IOL (ACIOL) was found in 3 eyes and one eye had peripheral anterior synechiae due to neovascular glaucoma.

Conclusion: UBM is a helpful diagnostic tool to evaluate causes of pseudophakic glaucoma through adequate visualization of different angle structures.

Keywords: UBM; hyphaema; neovascularization; pseudophakic glaucoma; ultrasound biomicroscopy.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
No UBM explanation for elevated IOP.
Figure 2
Figure 2
IOL haptic pushing iris (arrow) leading to iridocorneal apposition and angle closure.
Figure 3
Figure 3
Decentered PCIOL, haptic impacted in ciliary body (arrow) leading to chronic uveitis.
Figure 4
Figure 4
A, B Tilted IOL pushing iris anteriorly (arrow) causing peripheral anterior synechiae.
Figure 5
Figure 5
Soemmering’s ring (arrow), peripheral anterior synechiae.
Figure 6
Figure 6
Silicone oil in anterior chamber (arrow), seclusio pupillae.
Figure 7
Figure 7
Uveitis with iris bombe and peripheral anterior synechiae (arrow).
Figure 8
Figure 8
Haptic of ACIOL (arrow) inducing chronic irritation with pigment dispersion evident on slit lamp examination.
Figure 9
Figure 9
Peripheral anterior synechiae (arrow) due to neovascularization at angle.
See this image and copyright information in PMC

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