Case Of Acute Angle-closure Glaucoma Research Articles

The efficacy of the two-incision phacoemulsilication combined with trabeculectomy for acute angle-closure glaucoma with cataract

Objective To evaluate clinical efficacy of the two-incisions phacoemulsilication combined with trabeculectomy for the treatment of acute angle-closure glaucoma with cataract. Methods One hundred eyes of 100 cases of acute angle-closure glaucoma with cataract from Jan. 2014 to Sep. 2015 received phacoemulsilication combined with trabeculectomy. All cases were randomly divided into observation group and control group, 50 cases in each group. The control group were treated with surgery with single incision and the observation group with two-incisions. Visual acuity, intraocular pressure, bleb situation and complication after treatment in both groups were observed. Results The visual acuity and intraocular pressure at 1 month after surgery of two groups improved, the observation group was significantly better than the control group, the difference was statistically significant between the two groups (P=0.002). Functional filtration bleb of the observation group occupied for 96.0% and 78.0% in the observation group. The difference was significant between the two groups(P=0.016). Conclusion The efficacy of double incision phacoemulsification combined with trabeculectomy is better than that of single incision in the treatment of acute angle-closure glaucoma complicated with cataract. Key words: Phacoemulsification, trabeculectomy, two-incisions; Lens, intraocular; Glaucoma, angle-closure, acute; Cataract

Acute Visual Loss due to Acute Angle-Closure Glaucoma after Kidney Transplantation

Acute angle-closure glaucoma is an ocular emergency and is distinct due to its acute presentation, need for immediate treatment, and well-established anatomic pathology. Although some patients develop increased intraocular pressure after kidney transplantation, few patients are diagnosed with glaucoma. Most glaucoma that appears after kidney transplantation is of the open-angle type and is probably associated with steroid treatment. Acute angleclosure glaucoma after kidney transplantation is rare. We report a case of acute angle-closure glaucoma, suggested to be steroid independent that developed after kidney transplantation and resulted in progression to permanent visual loss.

Evaluation of Secondary Glaucoma Associated With Subluxated Lens Misdiagnosed as Acute Primary Angle-closure Glaucoma

To evaluate the causes of misdiagnosis in patients with acute angle-closure glaucoma secondary to subluxated lens, and postoperative outcomes. Retrospective clinical study. Five hundred twenty-six cases of acute angle-closure glaucoma were consecutively recruited from Zhongshan Ophthalmic Center between March 2003 and March 2009. Zonular dialysis, anterior chamber angle, and anterior chamber depth were examined by ultrasound biomicroscopy. Surgical therapy was performed according to the degree of zonular dialysis and angle closure. Thirty-one eyes (5.89%) with acute angle-closure glaucoma secondary to lens subluxation were misdiagnosed as acute primary angle-closure glaucoma. In these cases, the anterior chamber depth of the affected eyes was significantly shallower than the fellow eyes (1.34±0.45 vs. 2.27±0.44, P<0.05). The best-corrected visual acuity was significantly improved 3 months after surgery, and intraocular pressure was well controlled in all eyes. Mean intraocular pressure was 12.09±4.41 mm Hg without any medication at the final visit. The causes of misdiagnosis in patients with acute angle-closure glaucoma secondary to subluxated lens include neglected history and/or signs of ocular trauma. Lens extraction surgery was an effective therapy for these cases.

Angle Closure Glaucoma After Angiography of Carotid-Cavernous Fistula—A Case Report

Acute angle closure glaucoma (AACG) is a rare complication of carotid-cavernous fistula (CCF). However, rarer is iatrogenic AACG subsequent to CCF's standard treatment, endovascular embolization. To our knowledge, this is the first case in which AACG after angiography (a failed attempt at embolization) is treated primarily with embolization, and the first case of AACG and CCF that has yielded such a successful visual recovery.

A Case of Acute Angle-Closure Glaucoma in a Nanophthalmos Patient

Purpose: To present a case of acute angle-closure glaucoma in a nanophthalmos patient. Case summary: A 28-year-old woman visited the hospital for a sudden pain in the left eye, she had a small orbital bone and narrow palpebral fissurea in both eyes. Her intraocular pressure (IOP) was 58 mmHg in the left eye. The slit lamp examination showed shallow anterior chambers in both eyes, and the gonioscopic examination showed a closed angle in the left eye. The diameters of the corneas were 11 mm , and the axial lengths were 19.7 mm in the right eye and 19.6 mm in the left eye. The depths of the anterior chambers were 1.51 mm in the right eye and 1.82 mm in the left eye. The disease was diagnosed as acute angle-closure glaucoma in the left eye of the patient with nanophthalmos, and thus the IOP of the left eye was lowered using ophthalmic drugs and medications. Laser iridotomy was performed on both eyes. Conclusions: For around a year of follow-up after laser iridotomy, complications such as the rise of intraocular pressure and choroidal effusion were not observed. This suggests that laser iridotomy can be an effective treatment for acute angle-closure glaucoma accompanying nanophthalmos. J Korean Ophthalmol Soc 2010;51(2):303-306

Late Onset of Acute Angle-Closure Glaucoma Following Neodymium:YAG Laser Posterior Capsulotomy

Acute angle-closure glaucoma due to vitreous prolapse immediately following neodymium:YAG (Nd:YAG) laser posterior capsulotomy in eyes with posterior chamber intraocular lens implants is rare. Previously described cases were associated with advanced age, excessive amounts of laser energy, and a large-diameter capsular opening. The authors describe a case of acute angle-closure glaucoma occurring 21 days after Nd:YAG laser posterior capsulotomy in a young patient with a small-diameter capsule opening and a small amount of laser energy to stress the importance of close extended follow-up even in eyes with a theoretical low risk for this complication

Acute Angle-Closure Glaucoma from Spontaneous Massive Hemorrhagic Retinal Detachment

PurposeTo report a case of acute angle-closure glaucoma resulting from spontaneous hemorrhagic retinal detachment.MethodsAn 81-year-old woman visited our emergency room for severe ocular pain and vision loss in her left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye. The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle. In comparison, the right anterior chamber depth was normal and showed a wide, open angle. Computed tomography and ultrasonography demonstrated retinal detachment due to subretinal hemorrhage. After systemic and topical antiglaucoma medications failed to relieve her intractable severe ocular pain, she underwent enucleation.ResultsThe ocular pathology specimen showed that a large subretinal hemorrhage caused retinal detachment and pushed displaced the lens-iris diaphragm, resulting in secondary angle-closure glaucoma.ConclusionsProlonged anticoagulant therapy may cause hemorrhagic retinal detachment and secondary angle-closure glaucoma. If medical therapy fails to relieve pain or if there is suspicion of an intraocular tumor, enucleation should be considered as a therapeutic option.

Reply regarding “Angle closure glaucoma induced by ritodrine”

Reply regarding “Angle closure glaucoma induced by ritodrine”

Acute angle-closure glaucoma caused by vitreous prolapse after neodymium:YAG posterior capsulotomy

We report the second known case of acute angle-closure glaucoma from vitreous prolapse after neodymium:YAG (Nd:YAG) laser posterior capsulotomy in a patient with a posterior chamber intraocular lens (IOL). This is the first reported case to result in corneal decompensation that required penetrating keratoplasty. The rare complication of vitreous prolapse was unusual in this patient because of the presence of a posterior chamber IOL, a small 4.0 mm capsulotomy opening, and low (26 mJ) Nd:YAG laser energy.

Acute angle-closure glaucoma after hyperopic laser in situ keratomileusis

We report a case of acute angle-closure glaucoma 1 year after hyperopic laser in situ keratomileusis (LASIK). The glaucoma was resolved with laser iridotomy, and a prophylactic iridotomy was performed in the fellow eye. Corneal topography was performed 2, 5, and 18 weeks after the acute episode. A myopic shift occurred after the episode and resolved within 3 months. Hyperopic patients with narrow angles are at risk for angle closure and should be carefully monitored.

Acute Angle-closure Glaucoma Associated With Intranasal Cocaine Abuse

We report a case of acute angle-closure glaucoma associated with ipsilateral intranasal cocaine abuse. We examined and treated a 55-year-old white man who developed primary angle-closure glaucoma in the right eye shortly after intranasal cocaine abuse. The patient was successfully treated with Nd:YAG laser peripheral iridotomy on the right eye. Cocaine causes mydriasis and can induce angle closure in predisposed individuals.

Acute angle-closure glaucoma following botulinum toxin injection for blepharospasm.

Botulinum toxin inhibits acetylcholine release and therefore could cause mydriasis. We report a case of acute angle-closure glaucoma which occurred shortly after a series of injections of botulinum toxin round the eyelids for blepharospasm.

Long-term outcome of primary acute angle-closure glaucoma.

Factors influencing the long-term cure of 116 consecutive cases of acute angle-closure glaucoma, with at least one year's follow-up were examined. Delay in presentation and the time needed to terminate the attack were found to have a detrimental effect on the final outcome, while the height of the intraocular pressure at the time of the attack was found to be unimportant in predicting the long-term prognosis of the disease.

Acute angle-closure glaucoma associated with surgical anesthesia.

We reviewed the records of all inpatients of the UCLA Medical Center from 1955 to 1980 with the discharge diagnosis of "glaucoma." Nine cases of acute angle-closure glaucoma occurring after spinal or general anesthesia were identified among the 913 records reviewed. Of the nine cases, two were bilateral. Seven patients were female and two were male; the mean age was 63 years. Six of the nine surgical procedures were extraperitoneal and abdominal or pelvic. Parenteral atropine sulfate or scopolamine hydrobromide was administered to seven patients and ephedrine sulfate to four; drug-induced mydriasis may have contributed to this complication. Succinylcholine chloride, which causes contraction of the extraocular muscles, was administered to six patients. Additionally, psychological stress in the surgical patient may increase the risk of this disease by causing mydriasis. Our cases are compared with previous reports.

Epidemiology of acute angle-closure glaucoma: incidence and seasonal variations.

126 cases of acute angle-closure glaucoma were encountered in the total population of the Israel Negev region during 12 years. This constitutes an incidence of 4.2/100,000/year in the total population and 11.1/100,000 in the over-30 population. The female:male ratio was 2.1:1 and the most frequently affected age-group was the 51-60 one; when age adjustment was made for the total population, the risk was equally high for all ages above 50. The ethnic origin had no effect on the incidence. A statistically significant preponderance of attacks occurring during summer and winter was found.

Mydriatic effects of one-eight per cent phenylephrine. A potential cause of angle-closure glaucoma.

Sympathomimetic substances to whiten and soothe the eye are incorporated in numerous proprietary collyria. Phenylephrine, usually in ⅛% (0.125%) solution, is one such commonly used decongestant found in combination with a variety of agents, including antibiotics and sulfa drugs, corticosteroids, antihistamines, local anesthetics, antiseptics, and astringents. Indeed, even over-the-counter collyria contain phenylephrine and other eye whiteners. Until recently, we had thought the mydriatic effect of so dilute a solution as ⅛% phenylephrine to be inconsequential. Reported herein is a case of acute angle-closure glaucoma which led us to a critical examination of this supposition. Pertinent data being scarce, we decided to test the mydriatic action of ⅛% phenylephrine, the better to evaluate its safe or potentially hazardous use in the narrow-angle eye. Report of Case A 62-year-old white female complaining of itchy eyes sought the help of an ophthalmologist. Fourteen years previously she had had successful fistulizing surgery performed upon