Topic outline

  • Grand Rounds

    A patient presented for right eyelid drooping and redness. The patient had a remote history of retinopathy of prematurity (ROP) which had been treated with extensive retinal laser ablation as a neonate. The patient was found to have pachyphakia, microcornea, and acute angle closure of the right eye, with pachyphakia and microcornea of the left eye. He was treated with phacoemulsification and lens insertion on the right eye with goniosynechiolysis with significant post-operative improvement in pressure and pain. The syndrome of pachyphakia, microcornea, and angle closure (PMAC) is a group of findings that arises after non-surgical treatment of ROP. Post-ROP angle closure accounts for approximately 79% of juvenile angle closure, and thus recognition of this complex constellation of findings is essential. While anterior segment anatomy may make standard phacoemulsification with lens placement difficult, it can be accomplished using specialized tools. This treatment is efficacious and safe for the treatment of PMAC, and it has the benefit of preserving the vitreous and preventing aphakic complications.

    Presentation Date: 04/04/2024
    Issue Date: 04/19/2024