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- W1968052113 abstract "Vetter et al.1 describe a case of acute angle-closure glaucoma (ACG) after implantation of a toric implantable contact lens (ICL). They treated the patient by extracting the ICL, thereby reversing the acute angle closure. A neodymium:YAG (Nd:YAG) laser iridotomy had been done prior to the ICL implantation, and “transilluminescence was confirmed one day before surgery.” To date, I have treated 5 eyes with acute ACG following implantation of phakic posterior chamber intraocular lenses (ICLs) performed elsewhere. In each case, an Nd:YAG laser iridotomy had been done before the ICL implantation. I treated each eye with a surgical peripheral iridectomy. Postoperatively, intraocular pressures returned to normal values, the anterior chambers were deeper, and the lenses demonstrated normal vaulting. Unfortunately, mydriasis persisted, causing glare and an unsatisfactory cosmetic appearance. It may be that the Nd:YAG laser iridotomies were unreliable. We know that when a peripheral Nd:YAG laser iridotomy is performed in a case of acute ACG, an influx of pigment into the anterior chamber and a deepening of the anterior chamber must be observed to be certain the iridotomy is successful. Transillumination of the iridotomy may be misleading, and an open iridotomy could close spontaneously yet exhibit transilluminescence. The first step in treating acute ACG after ICL implantation should be a surgical peripheral iridectomy. The procedure is simple; it can be done under topical anesthesia and obviates the need to remove the ICL. It is preferable to perform the surgical iridectomy during ICL implantation. (It can be done with the vitreous cutter after the ICL is implanted.) The iridectomy not only decreases the incidence of acute ACG, it also precludes the need to perform an Nd:YAG laser iridotomy earlier, with the associated inconvenience and discomfort to the patient." @default.
- W1968052113 created "2016-06-24" @default.
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- W1968052113 date "2007-04-01" @default.
- W1968052113 modified "2023-09-25" @default.
- W1968052113 title "Surgical management of acute angle-closure glaucoma after implantation of a toric ICL" @default.
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- W1968052113 doi "https://doi.org/10.1016/j.jcrs.2006.11.021" @default.
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