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Case Rep Ophthalmol 2021 Sep-Dec;12(3):882-888. Epub 2021 Nov 2.

Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan.

An 85-year-old Japanese woman with acute primary angle closure in her right eye underwent cataract extraction. Because of the weakness of the Zinn's zonules, all of the lens tissue including the lens capsule was removed by phacoemulsification. Because of the absence of vitreous prolapse into the anterior chamber, vitrectomy was not performed. Read More

Am J Ophthalmol Case Rep 2019 Sep 1;15:100459. Epub 2019 May 1.

Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.

Purpose: Aphakic pupillary block glaucoma is a rare complication after congenital cataract surgery We describe the case of an infant with acute angle closure in an aphakic eye following congenital cataract lensectomy with anterior vitrectomy nine months prior. Potential pathophysiology and therapeutic strategies are discussed.

Observations: A one-year-old male infant presented to our emergency unit with right eye injection and pain. Read More

Cir Cir 2019 ;87(2):215-218

Facultad de Medicina, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México.

Background: Pupillary block induced by silicon oil in vitrectomized patients is a common condition usually treated with Nd-YAG laser iridotomy or with surgical removal of silicon oil.

Case Report: A case of silicone oil pupillary block glaucoma successfully treated with a 30 G needle transfixion technique is described. We performed a non-complicated vitrectomy surgery for retinal detachment with proliferative vitreoretinopathy that included lensectomy, inferior peripheral iridectomy, and silicone oil injection. Read More

BMC Ophthalmol 2018 Sep 14;18(Suppl 1):229. Epub 2018 Sep 14.

Princess Alexandra Eye Pavilion, Edinburgh, Scotland.

Background: We present a case of aphakic pupil block caused by vitreous prolapse into the anterior chamber following Nd:YAG capsulotomy.

Case Presentation: This resulted in advanced glaucoma in a young patient, which presented a significant clinical management challenge.

Conclusions: Ultimately, at the time of writing, her intraocular pressure and uveitis were well controlled, however the long-term outcome remains uncertain, given the uncompromising natural history of her complicated ocular condition. Read More

J Cataract Refract Surg 2017 05;43(5):639-642

From the Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China.

Purpose: To describe secondary pigment dispersion syndrome (PDS) and pigmentary glaucoma after secondary sulcus transscleral fixation of 1-piece hydrophobic acrylic foldable posterior chamber intraocular lenses (PC IOLs) in aphakic patients in a Chinese population.

Setting: Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China.

Design: Retrospective case series. Read More

BMC Ophthalmol 2016 May 17;16(1):58. Epub 2016 May 17.

Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.

Background: Aphakic glaucoma is a common complication after congenital cataract extraction, especially in those who have surgery during infancy. This case report describes a case of bilateral pupillary block glaucoma diagnosed with intraoperative ultrasound biomicroscopy (UBM) after removal of congenital cataract.

Case Presentation: We present a case report of a 9-month-old infant with bilateral corneal enlargement and ocular hypertension after uneventful removal of congenital cataracts. Read More

J AAPOS 2016 06 2;20(3):247-51. Epub 2016 May 2.

Department of Ophthalmology, Children's University Hospital Temple Street, Dublin, Ireland. Electronic address:

Purpose: To describe the long-term incidence of retinal detachment, intra- and postoperative complications, and visual and refractive outcomes of children with Marfan syndrome following lensectomy for ectopia lentis, with or without subsequent correction of aphakia using the Artisan aphakic iris-fixated anterior chamber intraocular lens.

Methods: The medical records of children treated at the Department of Ophthalmology, Children's University Hospital, Dublin, Ireland, from January 1, 1991, to December 31, 2011, were retrospectively reviewed. The primary outcome measure was rate of retinal detachment at final follow-up. Read More

Medicine (Baltimore) 2015 Aug;94(31):e1248

From the Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Uveitic glaucoma (UG) is secondary glaucoma, present as a clinical challenge in both diagnosis and management.We report a case of complex UG, which initially presented as pupillary block and rupture of the anterior lens capsule. We performed cataract extraction with preservation of posterior capsule. Read More

J AAPOS 2015 Jun;19(3):242-6

Ophthalmology Department, Faculty of Medicine, Cairo University & Research Institute of Ophthalmology, Cairo, Egypt.

Purpose: To evaluate the visual outcomes and complications after Artisan iris-claw lens implantation in aphakic children with insufficient capsular support.

Methods: In this prospective, interventional noncontrolled study, aphakic eyes of consecutive patients >2 years of age with insufficient capsular support who underwent Artisan intraocular lens (IOL) implantation between June 2011 and December 2012 were followed for 1 year. Patients with anterior chamber depth <3 mm, central endothelial cell density (CECD) <2500 cells/mm(²), uncontrolled glaucoma, or uveitis were excluded. Read More

JAMA Ophthalmol 2015 Feb 12;133(2):e141821. Epub 2015 Feb 12.

Br J Ophthalmol 2014 Sep 29;98(9):1291-5. Epub 2014 Apr 29.

Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Purpose: To evaluate clinical outcomes and complications after Descemet membrane endothelial keratoplasty (DMEK) and posterior iris-claw aphakic intraocular lens (IOL) implantation.

Methods: This prospective cohort study comprised seven consecutive eyes (seven patients) without adequate capsular support and bullous keratopathy undergoing posterior iris-claw aphakic IOL implantation and DMEK. Corneal transparency, central corneal thickness, endothelial cell density, visual outcomes and complication rates were measured during the follow-up. Read More

Int Ophthalmol 2015 Apr 12;35(2):233-40. Epub 2014 Apr 12.

Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India,

The purpose of this study was to describe a modified technique of sutureless DSAEK with continuous pressurized internal air tamponade. This was a prospective interventional case series, single-center, institutional study. Twenty-seven patients with corneal decompensation without scarring were included. Read More

Br J Ophthalmol 2014 May 31;98(5):658-63. Epub 2014 Jan 31.

Department of Cornea and Refractive Surgery, Instituto Microcirugia Ocular, , Barcelona, Spain.

Background/aims: To evaluate the efficacy, predictability, safety and complications of secondary iris-claw intraocular lens (IOL) implantation in aphakic eyes without capsular support.

Methods: Retrospective, non-comparative, interventional case series of 128 aphakic eyes, which consecutively underwent secondary iris-claw Artisan IOL (Ophtec BV) implantation, were included. Manifest refraction, uncorrected visual acuity, best-spectacle corrected visual acuity, biomicroscopy, tonometry, funduscopy and central endothelial cell count (cECC) were evaluated before surgery, and at yearly intervals up to 5 years. Read More

Int Ophthalmol 2014 Aug 1;34(4):913-7. Epub 2013 Oct 1.

Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran,

Closure of the peripheral iridectomy (PI) may lead to forward displacement of silicone oil (SO) in some but not all SO-filled aphakic eyes. In this study, we report three patients with a history of a combined three-port pars plana vitrectomy and cataract surgery, SO injection and inferior PI who underwent laser retinopexy a few months postoperatively. The postoperative courses of these patients were unremarkable except for the closure of the PI without anterior displacement of SO; however, a few hours after laser therapy the SO was displaced to the anterior chamber, leading to acute glaucoma in one of the cases. Read More

Am J Ophthalmol 2013 Aug 27;156(2):382-386.e1. Epub 2013 May 27.

Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.

Purpose: To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in children.

Design: Noncomparative retrospective cohort study.

Methods: setting: Institutional practice. Read More

Graefes Arch Clin Exp Ophthalmol 2013 Jun 29;251(6):1557-63. Epub 2013 Jan 29.

Department of Ophthalmology, China Medical University Hospital, No. 2, Yuh Der Road, Taichung, Taiwan.

Background: To describe a scleral indentation technique to enhance donor adherence in Descemet's stripping and automated endothelial keratoplasty (DSAEK) in patients with abnormal anterior segment.

Methods: In patients with visual potential, we performed transscleral fixation of a foldable intraocular lens (IOL) and DSAEK. In patients only for pain relief, we performed DSAEK without IOL implantation. Read More

Ophthalmic Surg Lasers Imaging 2010 Mar 9:1-3. Epub 2010 Mar 9.

Pupillary block is seen after pars plana vitrectomy (PPV) with gas or silicone oil endotamponade in aphakic eyes. A case of a pseudophakic patient with pupillary block glaucoma related to the migration of air into the anterior chamber was reported. A 76-year-old woman underwent combined PPV with air endotamponade and uncomplicated cataract extraction for epiretinal membrane and cataract. Read More

Cornea 2009 Jul;28(6):652-6

From the Cornea, Cataract, and External Disease Service, The Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.

Purpose: To report secondary angle closure caused by air migrating behind the pupil in the context of intraocular pressure (IOP) elevation in the early postoperative period after Descemet stripping endothelial keratoplasty (DSEK).

Methods: A retrospective case series was conducted on 100 consecutive DSEK cases from 90 patients undergoing DSEK because of corneal disease from Fuchs corneal dystrophy, pseudophakic bullous keratopathy, aphakic bullous keratopathy, and iridocorneal endothelial syndrome. Preoperative and postoperative slit-lamp examinations and IOP measurements were ascertained for all 100 eyes. Read More

Cornea 2009 Feb;28(2):157-62

From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Purpose: To determine the efficacy and postoperative complications of complex deep lamellar endothelial keratoplasty (DLEK) when used for the management of complex bullous keratopathy with severe vision loss.

Methods: Twelve consecutive eyes with severe bullous keratopathy and other associated intraocular abnormalities underwent complex DLEK which was combined with other intraocular surgeries such as vitrectomy, intraocular lens removal, and secondary intraocular lens implantation. An air bubble was used in 9 eyes and an air and C3F8 gas bubble in 3 eyes for tissue support. Read More

Arch Ophthalmol 2008 Oct;126(10):1351-6

Department of Ophthalmology, University Hospital Maastricht, Maastricht, the Netherlands.

Objective: To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK).

Methods: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK. Read More

Int Ophthalmol 2008 Jun;28(3):191-207

Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1091, USA.

Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period. Read More

Ophthalmology 2008 Sep 18;115(9):1517-24. Epub 2008 Apr 18.

Division of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miami, Florida 33418, USA.

Purpose: To compile a survey of complications during and after Descemet's stripping with automated endothelial keratoplasty (DSAEK) in 118 eyes conducted by cornea subspecialists at a single academic center.

Design: Retrospective case series.

Participants: One hundred eighteen eyes undergoing DSAEK in 99 patients. Read More

Ophthalmology 2007 Oct 29;114(10):1839-41. Epub 2007 May 29.

Service Ophtalmologie, Hôpital Purpan, Toulouse, France.

Purpose: To report an unusual cause of decreased vision in an aphakic patient.

Design: Interventional case report.

Participant: One patient. Read More

Eye (Lond) 2006 Dec 11;20(12):1360-5. Epub 2005 Nov 11.

SB Ankara Eye Hospital, Ankara, Turkey.

Purpose: To investigate the causes of glaucoma in children following removal of cataracts.

Methods: In total, 24 patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma following cataract removal were studied retrospectively. Cataract morphology, surgical technique, postoperative complications, time to glaucoma onset, gonioscopic findings, the presence of microcornea, and the histopathologic characteristics of the filtration angle in one case were the studied parameters. Read More

J Cataract Refract Surg 2004 Dec;30(12):2585-9

Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Purpose: To report the results of pars plana vitrectomy (PPV) for retained lens fragments with implantation of an Artisan intraocular lens (IOL) (Ophtec) to correct aphakia.

Setting: University-based referral center.

Methods: In this retrospective case-controlled study, patients who had had a PPV to remove dislocated lens fragments and implantation of an Artisan IOL for pseudophakic correction during initial cataract surgery or PPV were reviewed. Read More

Am J Ophthalmol 2003 Aug;136(2):364-5

Rotterdam Eye Hospital, Rotterdam, The Netherlands.

Purpose: To demonstrate how an inferior iridectomy prevents a pupillary block in aphakic patients with a silicone oil tamponade.

Design: Observational case series.

Methods: Photographs of two patients who had undergone vitrectomy, lensectomy, membrane peeling, silicone oil tamponade, and inferior iridectomy for a complex retinal detachment were evaluated. Read More

Optometry 2002 Nov;73(11):685-93

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

Background: Angle closure secondary to pupil block is an entity known to occur in aphakic and pseudophakic patients. In aphakic patients, typically the cause of the pupil block is vitreous prolapse (aphakic pupil block). In pseudophakic patients, the typical cause of the pupil block is an anterior chamber lens implant, often in the absence of an iridectomy (pseudophakic pupil block). Read More

Indian J Ophthalmol 2002 Sep;50(3):220-1

Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

We report the case of a 35-year-old aphakic patient who developed an intractable secondary glaucoma due to angle closure after pupillary block following the use of perfluoropropane (C3F8) gas at a nonexpansile concentration of 14%. Read More

Vet Ophthalmol 2002 Mar;5(1):3-7

Animal Eye Specialty Clinic, 2239 S. Kanner Highway, Stuart, FL 34994, USA.

Unilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2-year-old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé. Read More

Am J Ophthalmol 2001 Sep;132(3):414-6

Rayne Institute, Academic Department of Ophthalmology, St Thomas' Hospital, Lambeth Palace Rd., London, SE1 7EH United Kingdom.

Purpose: To describe pupil block glaucoma in phakic and pseudophakic patients after vitrectomy with silicone oil injection.

Design: Interventional case series.

Methods: Cases were collected from January 1997 to July 2000 from three tertiary referral centers. Read More