2996: phacolytic glaucoma after ruptured globe
In this highly challenging case, our guest surgeon, Professor Ramesh Ayyala from USF Tampa, tackles a complex presentation of phacolytic glaucoma following a ruptured globe. The patient suffered a traumatic cornea, iris, and lens perforation six weeks prior, and now presents with light perception (LP) vision and an intraocular pressure (IOP) of 28 mmHg. Managing this case requires a multi-step reconstructive strategy: clearing the inflammatory, leaking lens material that is clogging the trabecular meshwork, inserting an IOL, and performing a pupilloplasty to restore the distorted iris architecture. In this case it is a smaller, pinhole pupilloplasty technique where the pupil is intentionally made a bit off center to avoid the corneal scar. Watch the incredible surgical skill required to stabilize the anterior segment and control the glaucoma in an eye with such extensive prior trauma. What is your preferred approach for reconstructing the iris and managing lens-induced glaucoma after a severe globe injury? Please comment your strategies below
