A patient presented with uncontrolled intraocular pressure (IOP) on maximum medical therapy and had bilateral laser iridotomy. The patient was diagnosed with angle-closure glaucoma. Biometry measurements were consistent with nanophthalmos. The right eye underwent phacoemulsification with an intraocular lens implant, scleral window, and tube shunt implantation. 6 weeks after the surgery, the patient developed aqueous misdirection which required pars plana vitrectomy. To minimize the risk of aqueous misdirection of the left eye, posterior capsulotomy with anterior vitrectomy was performed in addition to phacoemulsification with intraocular lens implant, sclerectomy and shunt implantation. Both eyes developed pupillary membranes and the right eye required YAG laser for membrane removal. At the most recent follow-up visit, her visual acuity without correction was 20/40 bilaterally. IOP was improved in both eyes on one glaucoma medication.
Presentation Date: 12/15/2022
Issue Date: 01/06/2023