Case Rep Ophthalmol 2016;7:115–118 DOI: 10.1159/000444215 Published online: February 24, 2016
© 2016 The Author(s) Published by S. Karger AG, Basel 1663‒2699/16/0071‒0115$39.50/0 www.karger.com/cop
This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms Yujiro Mori Yoshifumi Ikeda Masaki Tanito
Ichiya Sano
Etsuko Fujihara
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan
Key Words Flat anterior chamber · Short axial length · Primary angle closure glaucoma · Acute intraoperative choroidal effusion · Capsular block syndrome · Cataract surgery · Vitrectomy · Neodymium:yttrium-aluminium-garnet laser Abstract A 54-year-old woman with an epiretinal membrane in her left eye accompanied by a shallow anterior chamber due to primary angle closure glaucoma underwent vitrectomy and cataract surgery. During the cataract surgery, immediately after the ultrasonic tip had been removed from the anterior chamber, anterior chamber flattening occurred. An intraoperative fundus examination showed the development of acute intraoperative choroidal effusion. Postoperatively, the anterior chamber remained shallow even after the choroidal detachment had subsided; capsular bag distension seen by ultrasound biomicroscopy suggested the development of early postoperative capsular block syndrome. After neodymium:yttrium-aluminiumgarnet laser capsulotomy, the anterior chamber deepened. Depending on the perioperative period, the mechanism of a flat anterior chamber can change, and understanding the underlying mechanisms is required for appropriate treatment. © 2016 The Author(s) Published by S. Karger AG, Basel
Masaki Tanito, MD, PhD Division of Ophthalmology, Matsue Red Cross Hospital 200 Horo-machi Matsue, Shimane 690-8506 (Japan) E-Mail [email protected]
Case Rep Ophthalmol 2016;7:115–118 DOI: 10.1159/000444215
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/cop
Mori et al.: A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms
Introduction
The anterior chamber can flatten as a result of various mechanisms, although each mechanism is relatively rare, and requires appropriate therapy based on the underlying etiology. We report a case with anterior chamber shallowing observed preoperatively, intraoperatively, and postoperatively resulting from different mechanisms. Case Presentation
A 54-year-old woman was referred to our hospital for surgical treatment of an epiretinal membrane in her left eye (OS). Preoperatively, the best-corrected visual acuity was 0.2 with a +4.25-diopter hyperopic correction, and the intraocular pressure (IOP) was 22 mm Hg with one ocular hypotensive medication OS. Slit-lamp examination showed a shallow anterior chamber with a van Herick grade I narrow angle (fig. 1a, b); gonioscopy revealed the presence of peripheral anterior synechia at a temporal anterior chamber angle (
© 2016 The Author(s) Published by S. Karger AG, Basel 1663‒2699/16/0071‒0115$39.50/0 www.karger.com/cop
This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms Yujiro Mori Yoshifumi Ikeda Masaki Tanito
Ichiya Sano
Etsuko Fujihara
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan
Key Words Flat anterior chamber · Short axial length · Primary angle closure glaucoma · Acute intraoperative choroidal effusion · Capsular block syndrome · Cataract surgery · Vitrectomy · Neodymium:yttrium-aluminium-garnet laser Abstract A 54-year-old woman with an epiretinal membrane in her left eye accompanied by a shallow anterior chamber due to primary angle closure glaucoma underwent vitrectomy and cataract surgery. During the cataract surgery, immediately after the ultrasonic tip had been removed from the anterior chamber, anterior chamber flattening occurred. An intraoperative fundus examination showed the development of acute intraoperative choroidal effusion. Postoperatively, the anterior chamber remained shallow even after the choroidal detachment had subsided; capsular bag distension seen by ultrasound biomicroscopy suggested the development of early postoperative capsular block syndrome. After neodymium:yttrium-aluminiumgarnet laser capsulotomy, the anterior chamber deepened. Depending on the perioperative period, the mechanism of a flat anterior chamber can change, and understanding the underlying mechanisms is required for appropriate treatment. © 2016 The Author(s) Published by S. Karger AG, Basel
Masaki Tanito, MD, PhD Division of Ophthalmology, Matsue Red Cross Hospital 200 Horo-machi Matsue, Shimane 690-8506 (Japan) E-Mail [email protected]
Case Rep Ophthalmol 2016;7:115–118 DOI: 10.1159/000444215
© 2016 The Author(s). Published by S. Karger AG, Basel www.karger.com/cop
Mori et al.: A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms
Introduction
The anterior chamber can flatten as a result of various mechanisms, although each mechanism is relatively rare, and requires appropriate therapy based on the underlying etiology. We report a case with anterior chamber shallowing observed preoperatively, intraoperatively, and postoperatively resulting from different mechanisms. Case Presentation
A 54-year-old woman was referred to our hospital for surgical treatment of an epiretinal membrane in her left eye (OS). Preoperatively, the best-corrected visual acuity was 0.2 with a +4.25-diopter hyperopic correction, and the intraocular pressure (IOP) was 22 mm Hg with one ocular hypotensive medication OS. Slit-lamp examination showed a shallow anterior chamber with a van Herick grade I narrow angle (fig. 1a, b); gonioscopy revealed the presence of peripheral anterior synechia at a temporal anterior chamber angle (
