Acute angle closure in a pseudophakic eye with pseudoexfoliative syndrome: management when conventional medical and laser therapies fail.
Hannah Kamgarpour, Grace A Borchert, Claire W Ruan et al.
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Case in brief
An 82-year-old woman with pseudoexfoliation syndrome and a history of pseudophakia presented with acute right eye pain, visual loss, and an intraocular pressure of 65 mmHg. Examination revealed a shallow anterior chamber and vitreous prolapse. After conventional treatments failed, office-based trans-pars plana needle aspiration of liquefied vitreous was performed, leading to immediate deepening of the anterior chamber and significant reduction in intraocular pressure. Visual acuity fully recovered, and intraocular pressure remained controlled with topical therapy after 7 months.
Diagnostic / clinical pearl
In cases of acute angle closure in pseudophakic eyes with pseudoexfoliation syndrome, consider office-based trans-pars plana needle aspiration as a potential emergency management option when conventional therapies are ineffective.