Biomaterial Database

Intraoperative reverse pupillary block during femtosecond laser-assisted cataract surgery in a patient with phacomorphic angle closure. 2014

Dilraj S Grewal, and Surendra Basti

From the Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

We report a patient with phacomorphic angle closure having femtosecond laser-assisted cataract surgery. A staged procedure was followed to achieve mydriasis and deepen the anterior chamber with bisulfate-free epinephrine (epi-Shugarcaine) and an ophthalmic viscosurgical device (OVD) prior to the femtosecond procedure. After the femtosecond laser was docked, the patient complained of discomfort in her eye and intraoperative optical coherence tomography imaging revealed a reverse pupillary block configuration. Software modifications were required to complete the procedure, following which partial OVD removal and anterior tenting of the pupil margin relieved the reverse pupillary block. In the fellow eye, intracameral bisulfate-free epinephrine alone was injected above and below the iris plane for intraoperative mydriasis and to deepen the anterior chamber, which prevented a reverse pupillary block. BACKGROUND Neither author has a financial or proprietary interest in any material or method mentioned.

UI	MeSH Term	Description	Entries
D007429	Intraocular Pressure	The pressure of the fluids in the eye.	Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D007431	Intraoperative Complications	Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.	Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D011681	Pupil Disorders	Conditions which affect the structure or function of the pupil of the eye, including disorders of innervation to the pupillary constrictor or dilator muscles, and disorders of pupillary reflexes.	Afferent Pupillary Defect,Efferent Pupillary Defect,Marcus-Gunn Pupil,Pupil Reaction Absent,Pupillary Functions, Abnormal,Deformed Pupil,Ectopic Pupil,Fixed Pupils,Keyhole Pupil,Non-Syphilitic Argyll-Robertson Pupil,Occluded Pupils,Pupil Malformations,Pupillary Anomaly,Pupillary Disorders,Pupillary Occlusion,Pupillary Paralysis,Pupillary Sector Paralysis,Pupillary Sphincter Rupture,Sector Pupil Palsy,Wernicke Hemianopic Pupil,Wernicke's Hemianopic Pupil,Abnormal Pupillary Function,Abnormal Pupillary Functions,Afferent Pupillary Defects,Anomalies, Pupillary,Anomaly, Pupillary,Argyll-Robertson Pupil, Non-Syphilitic,Deformed Pupils,Ectopic Pupils,Efferent Pupillary Defects,Fixed Pupil,Hemianopic Pupil, Wernicke,Hemianopic Pupil, Wernicke's,Keyhole Pupils,Malformation, Pupil,Malformations, Pupil,Marcus Gunn Pupil,Non Syphilitic Argyll Robertson Pupil,Occluded Pupil,Occlusion, Pupillary,Occlusions, Pupillary,Paralyses, Pupillary,Paralyses, Pupillary Sector,Paralysis, Pupillary,Paralysis, Pupillary Sector,Pupil Disorder,Pupil Malformation,Pupil, Deformed,Pupil, Ectopic,Pupil, Fixed,Pupil, Keyhole,Pupil, Marcus-Gunn,Pupil, Non-Syphilitic Argyll-Robertson,Pupil, Occluded,Pupil, Wernicke Hemianopic,Pupil, Wernicke's Hemianopic,Pupillary Anomalies,Pupillary Defect, Afferent,Pupillary Defect, Efferent,Pupillary Defects, Afferent,Pupillary Defects, Efferent,Pupillary Disorder,Pupillary Function, Abnormal,Pupillary Occlusions,Pupillary Paralyses,Pupillary Sector Paralyses,Pupillary Sphincter Ruptures,Pupils, Deformed,Pupils, Ectopic,Pupils, Fixed,Pupils, Keyhole,Pupils, Occluded,Reaction Absent, Pupil,Reaction Absents, Pupil,Rupture, Pupillary Sphincter,Ruptures, Pupillary Sphincter,Sector Paralyses, Pupillary,Sector Paralysis, Pupillary,Sphincter Rupture, Pupillary,Sphincter Ruptures, Pupillary,Wernickes Hemianopic Pupil
D002386	Cataract	Partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (Dorland, 27th ed)	Cataract, Membranous,Lens Opacities,Pseudoaphakia,Cataracts,Cataracts, Membranous,Lens Opacity,Membranous Cataract,Membranous Cataracts,Opacities, Lens,Opacity, Lens,Pseudoaphakias
D002387	Cataract Extraction	The removal of a cataractous CRYSTALLINE LENS from the eye.	Enzymatic Zonulolysis,Phakectomy,Cataract Extractions,Enzymatic Zonulolyses,Extraction, Cataract,Extractions, Cataract,Phakectomies,Zonulolyses, Enzymatic,Zonulolysis, Enzymatic
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D015812	Glaucoma, Angle-Closure	A form of glaucoma in which the intraocular pressure increases because the angle of the anterior chamber is blocked and the aqueous humor cannot drain from the anterior chamber.	Glaucoma, Closed-Angle,Glaucoma, Angle Closure,Glaucoma, Narrow-Angle,Glaucoma, Uncompensated,Glaucoma, Uncompensative,Angle Closure Glaucoma,Angle Closure Glaucomas,Angle-Closure Glaucoma,Angle-Closure Glaucomas,Closed-Angle Glaucoma,Closed-Angle Glaucomas,Glaucoma, Closed Angle,Glaucoma, Narrow Angle,Glaucomas, Angle Closure,Glaucomas, Angle-Closure,Glaucomas, Closed-Angle,Glaucomas, Narrow-Angle,Glaucomas, Uncompensated,Glaucomas, Uncompensative,Narrow-Angle Glaucoma,Narrow-Angle Glaucomas,Uncompensated Glaucoma,Uncompensated Glaucomas,Uncompensative Glaucoma,Uncompensative Glaucomas
D053685	Laser Therapy	The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.	Laser Knife,Laser Scalpel,Surgery, Laser,Vaporization, Laser,Laser Ablation,Laser Knives,Laser Photoablation of Tissue,Laser Surgery,Laser Tissue Ablation,Nonablative Laser Treatment,Pulsed Laser Tissue Ablation,Ablation, Laser,Ablation, Laser Tissue,Knife, Laser,Knifes, Laser,Knive, Laser,Knives, Laser,Laser Knifes,Laser Knive,Laser Scalpels,Laser Surgeries,Laser Therapies,Laser Treatment, Nonablative,Laser Treatments, Nonablative,Laser Vaporization,Nonablative Laser Treatments,Scalpel, Laser,Scalpels, Laser,Surgeries, Laser,Therapies, Laser,Therapy, Laser,Tissue Ablation, Laser