Phacolytic Glaucoma
Narrative Responses:
Purpose
To describe the postoperative outcomes of a patient with phacolytic glaucoma treated with manual small incision cataract surgery.
Methods
A 67-year-old man presented with sudden decrease in visual acuity, severe pain, redness, photophobia, tearing, and corneal opacity in the left eye for 3 days.The patient’s best-corrected visual acuity in the right eye was 20/70 and in the left eye was light perception. His IOP was 16 mmHg in the right eye and 56 mmHg in the left eye. Slit-lamp examination revealed an IOL in the right eye and the left eye with conjunctival hyperemia, ciliary reaction, corneal edema, intense flare with iridescent particles in the anterior chamber, and hipermature cataract.
Results
We diagnosed him with phacolytic glaucoma and started topical treatment with prednisolone, tropicamide with phenylephrine, and ocular antihypertensive treatment. Ultrabiomicroscopy and B-scan was made. One week later we did a manual small incision cataract surgery with IOL implant. The smear and culture of aqueous humor were negative for any organism. Histopathologic examination revealed the lens surrounded by inflammatory cells and multinucleated giant cells engulfing the lenticular fibre. One month postoperatively, his vision was 20/20, IOP of 16 mmHg and normal optic nerve head cupping in both eyes.
Conclusion
There was presence of lens particles in the ultrabiomicroscopy and of inflammation, histiocytic response, and giant cells seen around the lens material in the histopathologic examination, thus confirming the ongoing phacolytic process. The manual small incision cataract surgery led to recovery of symptoms and vision gain of 20/20.