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K. Medoruma, I. Henzan, T. Gaja, H. Nakamura, K. Hayakawa, S. Sawaguchi; Cataract Surgery for Acute Angle Closure Secondary to Scleral Buckling. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6087.
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© ARVO (1962-2015); The Authors (2016-present)
Acute Angle Closure(AAC) secondary to Scleral Buckling(SB) have been treated with Laser iridotomy or systemic steroid therapy. To our knowledge, this is the first report regarding cataract surgery(PEA+IOL) for AAC secondary to SB for retinal detachment patients.
Design of this study was retrospective, interventional, non-comparative case series. Three cases(1st:76 year-old-female, 2nd:69 year-old-male, 3rd:70 year-old-male) with AAC secondary to SB received cataract surgery. Detailed clinical courses, ocular biometry and Ultrasound Biomicroscopy(UBM) findings were reviewed.
Case 1; Axial length(AL) was 22.5mm, Anterior Chamber Depth(ACD) was 2.65mm(with central corneal thickness,CCT). Encircling SB (Buckle number 286) for Rhegmatogenous Retinal Detachment(RRD) was performed. Postoperatively, Intra Ocular Pressure(IOP) elevated to 32mmHg. UBM showed angle closure of 4 quadrats without pupillary block or Choroidal Detachment(CD). On 18th day after SB, Cataract surgery was performed. Case 2; AL was 23.7mm, ACD was 2.81mm(with CCT). Encircling SB (Buckle number 506) for RRD was performed. Postoperatively, IOP elevated to 34mmHg. UBM showed angle closure of 4 quadrants. In this case pupillary block and choroidal effusion were observed. On 14th day after SB, Cataract surgery was performed. After cataract surgery, UBM showed angle opening of 3 quadrants with no evidence of papillary block. UBM also showed narrow, occludable angle in the other eye. Case 3; AL was 22.6mm, ACD was 2.78mm(with CCT). Encircling SB (Buckle number 286) for RRD was performed. Postoperatively, IOP elevated to 31mmHg. UBM showed angle closure of 4 quadrants and neither pupillary block nor CD were observed. On 7th day after SB, cataract surgery was performed. After cataract surgery, UBM showed angle opening of 2 quadrants with plateau iris. In all cases, IOP returned to normal immediately and prolonged after cataract surgery.
Cataract surgery is effective for the treatment of AAC secondary to SB for RRD.
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