DR. ANKITA SHARMA

Dr. Prateek Nishant, DR. RAVI KUMAR, Dr. AMIT RAJ, Dr. BHAWESH SAHA

Abstract

Purpose: Pupillary block is a rare complication of laser posterior capsulotomy in pseudophakic eyes occurring immediately after the procedure or time after.

Methods: A 48-years male patient presented with right eye pain and redness for five days after having undergone Nd:YAG Posterior Capsulotomy. Visual acuity was 6/6, peripheral anterior chamber was shallow, pupil mid-dilated and IOL in the bag posteriorly. IOP was 35mmHg. A diagnosis of pupillary block was made.

Results: Atropine 1% eye drops brought the IOP down to 25mmHg within three hours. Tablets Acetazolamide, topical atropine and Brimonidine + Timolol drops were advised. Subsequent IOP spikes were controlled with intravenous mannitol, Nd:YAG peripheral iridotomy, tapering doses of topical prednisolone and continued topical antiglaucoma therapy. The patient maintained an IOP of 20mmHg.

Conclusion: Medical management, timely laser iridotomy and consistent follow-up avoided vision-threatening complications in the index case.

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