Abstract
Clinical case of successful treatment ocular hypertension caused by organic closure of anterior chamber angle after penetrating keratoplasty is presented. The patient underwent keratoplasty in the right eye and on the first day after the operation the clinic of acute glaucoma attack in the operated eye was revealed. In view lack of effect from medication and laser treatment carried out, the synechiae surgical removal was done. Carbachol Intraocular Solution (0.1 ml MIO-CHOL Sterile Solution, APPASAMY OCULAR DEVICES (P) LTD. (PHARMA DIVISION), India) was injected into anterior chamber to narrow the pupil. But its action turned out to be paradoxical – instead of constriction there was sharp pupil dilation. In addition to standard treatment, the patient received keratoprotection and reparative therapy. To restore neurotrophic processes in the iris, intravenous infusions of 1000 mg of gliatilin were first performed, followed by a switch to the tablet form of this drug. After 4 months, the patient experienced increase in uncorrected visual acuity to 0.1; best corrected visual acuity – up to 0.2 with diaphragm against the background of complete absence of signs of inflammation. The graft was completely transparent, the intraocular pressure – 19 mm Hg, mydriasis persisted 5–6 mm, the reaction of the pupil to light appeared, but was weakened. Key words: ocular hypertension after penetrating keratoplasty, acute glaucoma attack, synechiae surgical removal.
Published Version
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