Jacobs Journal of Ophthalmology

Tilting Of Foldable PCIOL Masquerading As Malignant Glaucoma

*Shakun Gupta
Department Of Ophthalmology, Indira Gandhi Eye Hospital & Research Centre, India

*Corresponding Author:
Shakun Gupta
Department Of Ophthalmology, Indira Gandhi Eye Hospital & Research Centre, India

Published on: 2019-06-19


Two females reported to our Glaucoma clinic with complaints of blurred vision & pain along with signs suggestive of malignant glaucoma post phacoemulsification cataract surgery with foldable PCIOL, operated elsewhere. B-scan showed posterior segment within normal limit, so ruled out suprachoroidal haemorrhage. We treated them first with YAG peripheral iridotomy (PI) & peripheral anterior hyaloidotomy through peripheral PI with antiglaucoma medications (AGM) & topical Atropine assuming the case to be of malignant glaucoma. But in follow up, anterior chamber (AC) was found to be shallow with one haptic of foldable PCIOL in sulcus tilting forward seen in dilated pupil under the effect of topical atropine responsible for causing condition masquerading as malignant glaucoma. Then, the cases were treated by redialing of foldable PCIOLs in bag in both the cases. Post redialing, there was improvement of visual acuity along with reformation of AC with normal depth & intraocular pressure (IOP) was also under control without AGM



Left eye best corrected visual acuity was 6/18, applanation tension was 21 mmHg, anterior chamber was shallow, immature cataract was present, rest anterior segment was within normal limit, gonioscopy showed occludable angle. Provisional diagnosis of malignant glaucoma was made in right eye & patient was treated with iv mannitol 20% 200 ml stat with eye drop of fixed combination of Timolol 0.5% & Brimonidine 0.2% BD, eye drop Brinzolamide 1% TDS and eye drop Travoprost 0.004% HS in right eye. Nd-YAG PI