Reverse pupillary block associated with pigment dispersion syndrome after in-the-bag intraocular lens implantation

• Published in: Journal of cataract and refractive surgery Vol. 39; no. 12; pp. 1925 - 1928
• Main Authors: Itagaki, Hideo, MD, Kunikata, Toshio, MD, Hiratsuka, Kentaro, MD, Saito, Junichiro, MD, Oshika, Tetsuro, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2013
• Subjects: Aqueous Humor - physiology; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - etiology; Glaucoma, Open-Angle - surgery; Gonioscopy; Humans; Intraocular Pressure - physiology; Iridectomy; Lens Implantation, Intraocular - adverse effects; Male; Middle Aged; Myopia, Degenerative - complications; Ophthalmology; Phacoemulsification - adverse effects; Pupil Disorders - diagnosis; Pupil Disorders - etiology; Pupil Disorders - surgery
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2013.08.020

A 61-year-old man with high myopia who had received a systemic α1A -adrenoceptor antagonist had phacoemulsification and in-the-bag intraocular lens implantation in the right eye. One day postoperatively, marked pigment dispersion in the anterior chamber, posterior bowing of the iris, and iridodonesis were noted associated with a subsequent elevation in intraocular pressure (IOP). Pharmacological pupil dilation was effective in reducing pigment dispersion and IOP, and laser peripheral iridotomy was performed to alleviate posterior bowing of the iris. We hypothesize that dynamic changes in the aqueous humor flow by cataract surgery and latent flaccidity of the iris due to the systemic α1A -adrenoceptor antagonist caused reverse pupillary block. High myopia may be another risk factor for this complication. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.