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Phacomorphic Glaucoma and Anterior Lens Capsule Rupture After Laser Peripheral Iridotomy

Patient with a history of multiple retinal detachments status post repair and brunescent cataract was seen at outside eye clinic with elevated intraocular pressure, eye pain and decreased vision. Vision was reported to be Light Perception and intraocular pressure was 42. Patient’s angle was noted to be narrow therefore laser peripheral iridotomy was indicated and performed. Six days later patient presented to our office with worsening pain. Exam was notable for shallow anterior chamber filled with lens particles which was concerning for a combined phacomorphic and lens particle glaucoma. Urgent cataract extraction was recommended. Intraoperative assessment revealed an anterior capsular tear (Argentinian Flag Sign) emanating from the inferior peripheral iridotomy without posterior extension. Cataract extraction was successfully performed with a 3-piece intraocular lens placed in the ciliary sulcus. At last follow up patient’s vision had improved to 20/250 with deep anterior chamber on exam and controlled intraocular pressure.

Presentation Date: 04/11/2024
Issue Date: 04/19/2024


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Include in Catalogue?: No
Presenter(s): Javier Nahmias, MD
Faculty Discussant(s): Arindel S. Maharaj, MD, PhD
Self enrollment (Student)