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JAMA Ophthalmol 2019 Apr 11;137(4):e184495. Epub 2019 Apr 11.

Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.

Eur J Ophthalmol 2019 Apr 5:1120672119841972. Epub 2019 Apr 5.

1 Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Purpose:: To report a case of phacolytic glaucoma with rupture of anterior lens capsule in a case of hypermature cataract.

Methods:: Case report and literature review.

Results:: An 80-year-old woman presented with cloudiness and pain in the left eye for 1 day. Read More

Kaohsiung J Med Sci 2019 Mar 19. Epub 2019 Mar 19.

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.

J Glaucoma 2018 Nov;27(11):e185

Sita Lakshmi Glaucoma Center, Anand Eye Institute, Habsiguda, Hyderabad, Telangana, India.

Nepal J Ophthalmol 2016 07;8(16):161-166

Introduction: Lens Induced Glaucoma (LIG), is one of commonest cause of secondary glaucoma due to senile cataracts. The purpose of this study was to see the outcome of cataract surgery in patients with LIG.

Methods: This was a prospective case series of 40 patients with LIG who presented to our hospital between April to June 2014. Read More

J Glaucoma 2017 May;26(5):e171-e173

Henry Ford Health System Department of Ophthalmology, Detroit, MI.

Phacolytic glaucoma is an open-angle glaucoma that occurs when lens proteins from hypermature cataracts seep through an intact anterior capsule and induce obstruction of the trabecular meshwork by inflammatory cells. We review the case of a 66-year-old man who presented with acute pain, a hypermature cataract, prominent anterior chamber crystals, and elevated intraocular pressure. After cataract surgery was performed, iridescent crystals were noted in the posterior chamber. Read More

J Curr Glaucoma Pract 2016 May-Aug;10(2):68-75. Epub 2016 Aug 5.

Postgraduate and Junior Resident, Department of Ophthalmology, Navodaya Medical College Hospital & Research Centre, Raichur, Karnataka, India.

Aims: To outline the different characteristics of glaucomas and to determine the risk factors and their consequences on postoperative visual acuity, intraocular pressure (IOP), and inflammation, including corneal changes and optic disk changes.

Settings And Designs: Longitudinal prospective study done over a period of 1.5 years in a medical college hospital. Read More

BMC Infect Dis 2015 Oct 28;15:476. Epub 2015 Oct 28.

Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.

Background: Intraocular tuberculosis is uncommon and has various clinical presentations. Lack of specific clinical clues can make the diagnosis challenging. The purpose of this study is to report a clinical presentation of tuberculous iridocyclitis that mimics phacolytic glaucoma and has a distinctive inflammatory deposit in the inner side of the cornea. Read More

BMC Ophthalmol 2014 Nov 19;14:133. Epub 2014 Nov 19.

Department of Ophthalmology, Gyeongsang National University, Colleage of Medicine, Jinju, South Korea.

Background: Phacolytic glaucoma is induced by lens protein or macrophages that have leaked through a macroscopically intact anterior lens capsule. Here, we report a case of phacolytic glaucoma with anterior lens capsule disruptions visualized by scanning electron microscopy (SEM).

Case Presentation: A 71-year-old man was referred to our institute for increased intraocular pressure (IOP) in the right eye. Read More

ISRN Ophthalmol 2013 25;2013:581727. Epub 2013 Jun 25.

Department of Ophthalmology, Rural Medical College of Pravara Institute of Medical Sciences, Loni, Taluka Rahata, District Ahmednagar, Maharashtra 413736, India.

Purpose. To determine the clinical profile of lens-induced glaucoma (LIG), reasons for late presentation, and outcome of current management. Methods. Read More

Arch Soc Esp Oftalmol 2015 Jan 1;90(1):40-3. Epub 2014 Jan 1.

Novovision, Madrid, España; Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España; Departamento de Ciencias Morfológicas y Cirugía, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España.

Case Report: A case is presented of an acute onset lens particle glaucoma originating from a crystalline lens spontaneously dislocated into the vitreous for more than 20 years in a patient diagnosed with Marfan syndrome.

Discussion: Marfan syndrome is a connective tissue disorder with autosomal dominant inheritance caused by fibrillin gene mutation. Ectopia lentis is the predominant ocular abnormality and a major diagnostic criterion. Read More

Malays Fam Physician 2014 31;9(2):48-52. Epub 2014 Aug 31.

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia.

Objective: To determine the clinical presentations, management and outcome of lens-induced glaucoma (LIG) in Hospital Universiti Sains Malaysia.

Methods: A retrospective review was done among the existing patients of Hospital Universiti Sains Malaysia from January 2003 to December 2008. Patients with LIG were included and exclusion criteria were applicable for those who had glaucoma or other underlying causes of glaucoma. Read More

Malays Fam Physician 2013 30;8(1):33-7. Epub 2013 Apr 30.

Cataract is the most common cause of blindness in the world. An attack of phacolytic and phacomorphic glaucoma as a result of neglected cataract constitutes a medical emergency that must be addressed immediately. Ocular emergencies such as these is challenging for the surgeon with guarded or poor prognosis. Read More

BMJ Case Rep 2012 Jul 25;2012. Epub 2012 Jul 25.

Department of Ophthalmology, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India.

Vet Ophthalmol 2013 May 19;16(3):180-5. Epub 2012 Jul 19.

Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive 53706, Madison, WI, USA.

Objective: To summarize the clinical and pathologic findings in a group of dogs and cats with progressive clinical ocular disease, which were diagnosed with suppurative endophthalmitis and lens capsule rupture.

Animals Studied: Twenty cats and forty-six dogs that underwent unilateral enucleation or evisceration for intractable uveitis and/or glaucoma.

Procedure: Biopsy submission requests and microscopic case material were evaluated for clinical and histological features, including history of ocular trauma, duration of ocular disease, pattern of inflammation, and the presence of intralenticular microorganisms. Read More

Asia Pac J Ophthalmol (Phila) 2012 Mar-Apr;1(2):113-9

From the *Aravind Eye Hospital, Pondicherry, India; †The University of California, San Francisco, CA; ‡Cambridge Institute of Public Health, University of Cambridge, United Kingdom; §Dr. Gogate's Eye Clinic, Pune; and ¶Vision Research Foundation, Sankara Nethralaya, Chennai, India.

We aim at reviewing published peer-reviewed studies that evaluate the safety and efficacy of manual small incision cataract surgery (MSICS). Literature searches of the PubMed and the Cochrane Library databases were conducted with no date restrictions; the searches were limited to articles published in English only. All publications with at least level II and III evidence were studied and surgical techniques were analyzed. Read More

J Glaucoma 2012 Apr-May;21(4):248-9

Glaucoma Sector, Ophthalmology Department, Geneva University Hospitals, Geneva, Switzerland.

We report a case of acute phacolytic glaucoma in which only protein was present in the anterior chamber without macrophages. We propose that this study represents a type of phacolytic glaucoma characterized by a hyperacute presentation caused by rapid leakage of degenerated lens proteins into the aqueous humor as opposed to a second type with a more gradual onset and with phacolytic macrophages in the aqueous humor resulting from an immunologic response to liquefied lens proteins. Thus, 2 forms, perhaps at ends of a spectrum of clinical manifestations of phacolytic glaucoma, may exist with distinct characteristics and pathophysiology. Read More

Case Rep Ophthalmol Med 2011 20;2011:850919. Epub 2011 Dec 20.

Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Orissa 751024, India.

The differential diagnoses for phacolytic glaucoma are acute angle closure glaucoma, open angle glaucoma with uveitis, neovascular glaucoma, and glaucoma secondary to trauma. We report an unusual case where the dislocated cataractous lens firmly adherent to the corneal endothelium evoked a cellular reaction similar to phacolytic glaucoma but clinically appeared like a deep corneal abscess. The 73-year-old lady presented with severe photophobia, pain, and redness in the left eye for two months despite being on antibiotics and antifungals. Read More

Retina 2010 Jul-Aug;30(7):1051-7

Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Purpose: The purpose of this study was to describe the clinical characteristics and management of patients with bacterial endophthalmitis after an intravitreal antivascular endothelial growth factor injection.

Methods: This is a retrospective chart review of all patients admitted with suspected endophthalmitis from 2006 to 2008.

Results: Endophthalmitis was verified by positive Gram stain and culture in nine eyes. Read More

Can J Ophthalmol 2009 Feb;44(1):112

Kathmandu Univ Med J (KUMJ) 2006 Jan-Mar;4(1):30-3

National Academy of Medical Sciences, Nepal Eye Hospital, Tripureshwor, Kathmandu, Nepal.

Lens induced glaucoma is one of the important cause of secondary glaucoma in our population. Retrospective analysis of 40 cases of lens induced glaucoma presenting to Nepal Eye Hospital from January 2002 to December 2004 were analyzed to find the prevalence of sex, age, visual outcome, IOP control, and duration between appearance of symptoms and surgical invention. Females out numbered male (55:45 percent). Read More

Br J Ophthalmol 2007 Mar;91(3):279-81

Aravind Eye Hospital, Thavalakuppam, Pondicherry- 605 007, India.

Aims: To evaluate the safety, visual outcome and complications of manual small incision cataract surgery (MSICS) in the treatment of patients with phacolytic glaucoma.

Methods: In a nonrandomised interventional case series, 33 consecutive patients with phacolytic glaucoma underwent cataract extraction by MSICS, with staining of the anterior capsule by trypan blue.

Results: The mean preoperative intraocular pressure (IOP) was 46. Read More

Br J Ophthalmol 2007 Mar;91(3):269-70

J Cataract Refract Surg 2005 Sep;31(9):1829-30

Department of Ophthalmology, Centre Hospitalier Universitaire Sart Tilman, University of Liège, Liège, Belgium.

We report a case of phacolytic glaucoma in which spontaneous absorption of the hypermature lens allowed a patient who refused surgery to recover a normal pressure and satisfactory visual acuity. Read More

Indian J Ophthalmol 2001 Jun;49(2):103-7

Sagarmatha Choudhary Eye Hospital, Lahan, Nepal.

Purpose: To determine the frequency and types of lens-induced glaucoma (LIG), reasons for late presentation and outcome of current management.

Methods: Prospective case series of 413 patients/eyes with LIG over a 12-month period in 1998; 311 of these patients underwent cataract surgery. Visual acuity and intraocular pressure (IOP) were pre- and postoperatively assessed. Read More

Indian J Ophthalmol 2005 Mar;53(1):77

Arch Soc Esp Oftalmol 2005 Jan;80(1):27-34

Unidad de Oncología Ocular, Hospital Clínico Universitario, Valladolid, Spain.

Purpose: To present a series of patients with uveal melanoma masquerading as ocular hypertension.

Methods: Patients diagnosed with uveal melanoma were reviewed, selecting those cases with initial presentation as secondary unilateral glaucoma. Clinical and histopathological information useful for prognosis was examined, such as anterior border localization, size and shape of the tumor, associated ocular pathology, cell type and degree of extraocular extension. Read More

Optometry 2004 Sep;75(9):571-6

Nova Southeastern University, College of Optometry, Ft. Lauderdale, Florida 33328, USA.

Background: Phacolysis involves the breakdown of a hypermature cataract, causing an antigenic reaction to the lens proteins released into the anterior chamber with subsequent inflammation. To date, the time it takes for a crystalline lens to reach hypermaturity and induce a phacolytic response has never been clearly detailed. It is believed that cataract maturation is a slow process. Read More

Ocul Immunol Inflamm 2004 Sep;12(3):215-25

University Eye Clinic of Ioannina, Ioannina, Greece.

Background: Cytology of the aqueous humor can confirm the diagnosis of many intraocular conditions by revealing inflammatory cells, ghost red cells, lens material, and microorganisms.

Purpose: The purpose of this study was to emphasize the contribution of aqueous humor fine needle aspiration cytology in cases where there is a clinical diagnostic dilemma whether an infectious or a noninfectious inflammatory process of the uvea is present.

Methods: Collection of 0. Read More

Klin Oczna 2002 ;104(5-6):350-3

II Kliniki Okulistyki Akademii Medycznej w Lublinie.

Purpose: The aim of this study was to describe the results of hypermature cataract surgery, complicated with phacolytic glaucoma.

Materials And Methods: Observations were done on 44 patients treated in the II Ophthalmic Clinic of Medical Academy in Lubling, during 1998-2000 years. The group consisted of 18 females and 26 males, with the age ranging from 50 to 84. Read More

Eye (Lond) 2003 Mar;17(2):243-4

Bournemouth Eye Unit, Royal Bournemouth Hospital, UK.

This case report highlights the successful management, by vitrectomy alone, of a case of chronic phacolytic glaucoma secondary to a dislocated hypermature lens in the vitreous of a patient with ectopia lentis et pupillae (ELP). The features and complications of ELP are discussed. Read More

Am J Ophthalmol 1999 Dec;128(6):762-3

The Sussex Eye Hospital, Brighton, England.

Purpose: To determine the successful treatment of unilateral phacolytic glaucoma by vitrectomy and trabeculectomy in a patient with homocystinuria whose lens had dislocated into the vitreous at least 15 years earlier.

Methods: In a 32-year-old woman with homocystinuria, bilateral dislocation of the lens into the vitreous, and phacolytic glaucoma in her left eye a three-port pars plana vitrectomy was performed with the patient under general anesthesia. The lens was removed and a trabeculectomy fashioned. Read More

Am J Ophthalmol 1999 Oct;128(4):507-9

Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.

Purpose: To report a case of corneal opacity and iatrogenic cataract after laser-assisted in situ keratomileusis.

Method: Case report. A 44-year-old man was initially seen with a traumatic cataract, corneal stromal opacity, and defect of the endothelium in the right eye after laser-assisted in situ keratomileusis performed by a plastic surgeon who had no ophthalmologic training. Read More

Ophthalmic Res 1999 ;31(5):337-45

Departments of Pathology and Ophthalmology, Scott & White Clinic and Memorial Hospital, Scott, Sherwood and Brindley Foundation, Texas A & M University Health Science Center, College of Medicine, Temple, TX 76508, USA.

Purpose: To determine if measurement of lens protein in serum is a feasible means to gain information on the physiologic status of the lens in human subjects.

Methods: The gamma-crystallin concentration was measured by a sandwich radioimmunoassay in the sera of 280 subjects aged 25-94 years. Medical records were reviewed for diagnoses of cataract and aphakia. Read More

Indian J Ophthalmol 1998 Sep;46(3):139-43

Schell Eye Hospital, Vellore, India.

We retrospectively analyzed 135 eyes with phacolytic glaucoma. A trabeculectomy was added to standard cataract surgery if symptoms endured for more than seven days, or if preoperative control of intraocular pressure (IOP) with maximal medical treatment was inadequate. In the early postoperative period, IOP was significantly lower in the combined surgery group (89 eyes) compared to the cataract surgery group (46 eyes) (p < 0. Read More

Ophthalmic Surg Lasers 1998 Nov;29(11):880-9

VST Center for Glaucoma Care, Hyderabad, India.

Background And Objective: To evaluate long-term intraocular pressure (IOP) control and visual outcome of patients with phacolytic glaucoma.

Patients And Methods: Forty-five consecutive eyes of 45 patients with phacolytic glaucoma operated on between January 1990 and December 1995 and who had completed at least 1 year of follow-up were included in the study. Of the 45 eyes, 17 eyes underwent extracapsular cataract extraction (ECCE) with primary posterior chamber intraocular lens (PC IOL) implantation (group 1). Read More

Oftalmologia 1998 ;42(1):10-2

Clinica de oftalmologie, Spitalul Universitar Bucureşti.

Phacotopic glaucomas or hypertonias due to lens movements are not rarely in ophthalmology. They are often due to a traumatic pathology. They are seldom due to a congenital or acquired zonular disease. Read More

Indian J Ophthalmol 1997 Mar;45(1):53-9

VST Centre for Glaucoma Care, L.V. Prasad Eye Institute, Hyderabad, India.

Ophthalmic Surg Lasers 1996 Oct;27(10):839-43

Schell Eye Hospital, Christian Medical College, Vellore, India.

Background And Objective: To report five cases of vitreous opacification in phacolytic glaucoma (PG).

Patients And Methods: The records of patients with PG were retrospectively reviewed. A total of 135 eyes with PG were studied to determine the presence of vitreous opacification. Read More

Indian J Ophthalmol 1996 Sep;44(3):149-55

Aravind Eye Hospital, Madurai.

Lens induced glaucomas are a common occurrence in India. An attempt was made to understand the clinical modes of presentation and post operative visual results in 93 patients with lens induced glaucoma, 49 phacomorphic and 44 phacolytic, attending our institute during 1994. All these patients were subjected to a planned extracapsular cataract extraction. Read More

J Cataract Refract Surg 1996 Jun;22(5):633-6

Department of Ophthalmology, Royal Infirmary, Bradford, England.

We describe nine patients who had phacomorphic or phacolytic glaucoma. After intraocular pressure (IOP) was reduced medically, all patients had extracapsular cataract extraction. All had intraocular lens implantation except one. Read More

J Cataract Refract Surg 1996 Apr;22(3):288-93

VST Centre for Glaucoma Care, L.V. Prasad Eye Institute, Hyderabad, India.

Performing endocapsular surgery can be more difficult in eyes with phacolytic glaucoma because the capsule is fragile and zonules are weak. In this study, I investigated the safety and efficacy of a technique for performing endocapsular surgery with and without posterior chamber intraocular lens (IOL) implantation in 19 eyes of 19 patients with phacolytic glaucoma. This technique involves aspiration of the fluid cortex from the capsular bag using a 26 gauge bent needle. Read More

Am J Ophthalmol 1994 Dec;118(6):807-8

Department of Ophthalmology, Cleveland Clinic Foundation, OH 44195-5024.

Purpose/methods: We observed an unusual case of lens-induced glaucoma that occurred 65 years after congenital cataract extraction. We successfully treated the patient by removing the residual lens material with pars plana vitrectomy.

Results/conclusions: The intraocular specimen exhibited lens material, epithelial cells, and macrophages. Read More

Indian J Ophthalmol 1994 Sep;42(3):145-7

Gandhi Medical College.

Phacolytic glaucoma has traditionally been treated with intracapsular lens extraction to avoid any anaphylaxis. Various mechanisms have been described for the rise of intraocular pressure in these cases. The present study was undertaken to evaluate the response of extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation (PC IOL) in five cases of phacolytic glaucoma that occurred between March 1989 and August 1990. Read More

Ann Acad Med Singapore 1993 Nov;22(6):891-4

Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.

A retrospective study of 995 eyes that had undergone cataract surgery between January and March 1990 revealed that one in 20 (50 eyes) were advanced cataracts which, by our definition, included hypermature, Morgagnian and intumescent cataracts. Thirty percent of these cases suffered from cataract-related complications preoperatively: phacomorphic glaucoma (12/50 eyes), phacolytic glaucoma (1/50 eyes), and subluxed cataract without trauma (2/50 eyes). Cataract surgery in these advanced cataracts produced significantly poorer results than the rest. Read More

Int Ophthalmol 1993 Oct;17(5):289-93

Department of Ophthalmology, Porto Medical School/S. João Hospital, Portugal.

The pathogenesis of lens-induced uveitis and phacolytic glaucoma is still not fully understood. The authors report a case of a 62-year-old white female, with bilateral lens dislocation into the vitreous, who presented clinical and pathological features of phacolytic glaucoma in the left eye. The ultrastructural study of aqueous and vitreous aspirates showed lenticular fragments and macrophages with lipofuscin granules and phagocytic vacuoles containing lens proteins. Read More

J Am Vet Med Assoc 1992 Sep;201(6):921-6

Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606.

During a 5-year period, phacolytic uveitis was diagnosed in 202 eyes of 151 dogs admitted to the veterinary teaching hospital. The diagnosis of phacolytic uveitis was based on the finding of a cataractous lens and anterior uveitis, unassociated with other identifiable causes of uveal inflammation. The most commonly affected breeds were the Toy and Miniature Poodle (35%) and the American Cocker Spaniel (19%). Read More

Oftalmologia 1992 Jul-Sep;36(3):207-13

Secţia de Oftalmologie Tîrgovişte.

The phacoantigenic uveitis is a self-immune affection at the lens proteins, which may be determined by a 3rd-type hypersensitivity, and some sterner forms by a 4th-type hypersensitivity. In phacolytic glaucomas, the macrophagic reaction at degraded lens proteins obstructs the trabecular gaps, determining the raise of ocular tension with the appearance of secondary glaucomas. Read More

Doc Ophthalmol 1992 ;81(3):317-38

Department of Ophthalmology, Lenox Hill Hospital, New York.

The crystalline lens is implicated as a causative element in producing several forms of glaucoma. Etiologically they represent a diversity in the presentation of the glaucomatous process. These conditions include glaucoma related to: lens dislocation (ectopia lentis), lens swelling (intumescent cataract), classical pupillary block, aqueous misdirection--ciliary block, phacoanaphylaxis, lens particle, and phacolytic glaucoma. Read More

Curr Eye Res 1992 ;11 Suppl:187-91

Department of Ophthalmology, St Thomas' Hospital, UMDS, London, UK.

The presence of interleukin 6 (IL-6), interleukin 1 (IL-1), interleukin 2 (IL-2) and tumour necrosis factor (TNF) was investigated in vitreous and aqueous aspirates from eyes undergoing vitrectomy for the treatment of different inflammatory conditions. Cadaveric vitreous from 10 normal subjects were used as controls. IL-6 was observed in 5 specimens from eyes with idiopathic uveitis (range = 26-264 pg/ml), in 2 specimens from eyes with uveitis complicated with retinal detachment (28 and 279 pg/ml, respectively), in 6 samples from eyes with diabetic retinopathy (range = 5-480 pg/ml), in one sample from an eye with phacolytic glaucoma (1190 pg/ml) and in one specimen from an eye with Behçet's disease (366 pg/ml). Read More