J Korean Ophthalmol Soc > Volume 57(10); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(10):1661-1665.
DOI: https://doi.org/10.3341/jkos.2016.57.10.1661    Published online October 15, 2016.
Pigment Dispersion Syndrome and Reverse Pupillary Block after Implantable Collamer Lens with Central Hole Implantation.
Su Chan Lee, Hye Jin Chung, Yun Suk Chung, Jin Young Choi, Kee Yong Choi, Mi Jeung Kim
HanGil Eye Hospital, Incheon, Korea. artemismj@hanmail.net
광학부 중앙 원공을 가지는 안내렌즈삽입술 후 발생한 색소분산증후군 및 역 동공 차단
이수찬⋅정혜진⋅정윤석⋅최진영⋅최기용⋅김미정
한길안과병원
Abstract
PURPOSE
To report a case of pigment dispersion syndrome and reverse pupillary block secondary to the implantation of implantable collamer lens (ICL) with a central hole (AQUA ICL®) that was treated with ICL removal and laser peripheral iridotomy (LPI). CASE SUMMARY: A 29-year-old woman with myopia in both eyes underwent implantation of AQUA ICL®. Four weeks postoperatively, the intraocular pressure (IOP) increased to 34 mm Hg and the patient showed pigment dispersion syndrome in both eyes. Since the IOP did not reduce with the maximum tolerable medical therapy, the ICLs were removed 8 weeks after implantation. The pigment dispersion subsided and IOP reduced shortly after ICL removal. However, 4 weeks after removal of ICL, posterior iris bowing and reverse pupillary block occurred in the right eye and the IOP increased to 46 mm Hg. LPI was performed in the right eye, and the reverse pupillary block was dissolved after a reduction in pigment dispersion. The IOP subsequently normalized to 13 mm Hg. Two weeks later, prophylactic LPI was performed in the left eye. Four weeks after prophylactic LPI, selective laser trabeculoplasty was performed on both eyes. As a result, the IOP was 11 mm Hg in the right eye and 12 mm Hg in the left eye after 4 weeks of treatment with topical IOP-lowering medications. CONCLUSIONS: The present case indicates that implantation of ICL with a central hole can lead to early postoperative pigment dispersion syndrome. When this condition persists and is accompanied by reverse pupillary block after ICL removal, LPI can be partially effective.
Key Words: Implantable collamer lens;Laser peripheral iridotomy;Pigment dispersion syndrome;Reverse pupillary block


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