MANAGEMENT CASE OF POST PHAKIC INTRAOCULAR LENS IMPLANT IN HIGH MYOPIA WITH COMPLICATED CATARACT AFTER VITRECTOMY: POST SURGERY CHALLENGES
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Abstract
Introduction: To highlight the therapeutic dilemma in managing complications in high myopia patient with complicated cataract after vitrectomy who previously had refractive surgery.
Case Report: A 37-years old man, presented with half the right eye view was being blocked by a black curtain for one week before admission. He had a history of high myopia on both eyes and underwent phakic intraocular lens (PIOL) implantation 12 years ago. Presenting visual acuity (VA) of the right eye was hand motion (HM). Retinal detachment (RD) on inferior side, and clear lens with anterior chamber (AC) PIOL were found in the examination. Patient underwent vitrectomy, endolaser, and silicone oil in the next four days. A sudden severe pain with red-eye was found one month after surgery, intraocular pressure (IOP) was increased to 43 mmHg, the lens was white opaque with lens material seen in AC.
Discussion: The diagnosis of traumatic cataract and lens-particle-induced glaucoma was made. Lens mass evacuation surgery was performed after initial antiglaucoma medication. Posterior capsule rupture was found intraoperatively with only a small amount of lens mass remaining. Visual acuity result after the second surgery is still dissatisfied with the presence of rubeosis iridis, with the possibility of retinal re-detachment was still present.
Conclusion: High myopia still poses a greater risk of ocular complications. It can be corrected by refractive surgery, with expensive cost and it will not prevent potential future ocular problems. Repeated assessment before and after refractive surgery procedure is mandatory in order to prevent sight-threatening complications of high myopia which might lead to other blinding complications.
Keywords
high myopia, refractive surgery, retinal detachment, lens-particle glaucoma
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References
2. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123:1036-42.
3. Ang REY, Camus EE, Rivera MCR, Vizconde DC, Canilao LMB, Valencia NZR. Demographic and clinical profile of patients who underwent refractive surgery screening. Philipp J Ophthalmol. 2015;40: 64-71.
4. Wolffsohn JS, Calossi A, Cho P, Gifford K, Jones L, Jones D, et al. Global trends in myopia management attitudes and strategies in clinical practice. Contact Lens and Anterior Eye. 2019. p. 1-9.
5. Saw SM, Gazzard G, Shih-Yen EC, Chua WH. Myopia and associated pathological complications. Ophthalmic Physiology and Optics. 2005;25(5):381-91.
6. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31(6):622-60.
7. Tsai A, Wong C, Lim L, Yeo I, Wong D, Wong E et al. Pediatric retinal detachment in an asian population with high prevalence of myopia. Retina. 2019;39:1751-1760.
8. Irfani I, Kartasasmita AS. Pediatric retinal detachment in Indonesia: Clinical characteristics, risk factors, and treatment outcomes. Open Journal of Ophthalmology. 2017;7: 24
9. Belin P, Parke D. Complications of vitreoretinal surgery. Current Opinion in Ophthalmology. 2020;31:167-73.
10. Znaor L, Medic A, Binder S, Vucinovic A, Marin Lovric J, Puljak L. Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments. Cochrane Database of Systematic Reviews. 2019.
11. Elhousseini Z, Lee E, Williamson T. Incidence of lens touch during pars plana vitrectomy and outcomes from subsequent cataract surgery. Retina. 2016;36:825-9.
12. Su Y, Mao Z, Liu Y, Yang Y, Liu X. Late-onset lens particle glaucoma as a consequence of posterior capsule rupture after pars plana vitrectomy. Eye Sci. 2012;27:47-9.
13. Gujjula C, Kumar S, Varalakshmi U, Shaik M. Study of the incidence, mechanism, various modes of presentation and factors responsible for the development of lens induced glaucomas. Al-Basar International Journal of Ophthalmology. 2015;3:56.
14. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research. 2012;31: 622-60.
15. Cantor LB, Rapuano CJ, Cioffi GA, editor. Refractive Surgery. San Fransisco: American Academy of Ophthalmology; 2019. p. 11-38.
16. Rishi P, Attiku Y, Agarwal M, Narayanan R, Talwar D, Srinivasan B et al. Retinal Detachment after Phakic Intraocular Lens Implantation: A 10-Year Multicenter Study. Ophthalmology. 2019;126(8):1198-1200.
17. Jiang T, Chang Q, Wang X, Huang X. Retinal detachment after phakic intraocular lens implantation in severe myopic eyes. Graefe's Archive for Clinical and Experimental Ophthalmology. 2012;250: 1725-1730.
18. Shah MA, Shah SM, Shah SB, Patel CG, Patel UA. Morphology of traumatic cataract: does it play a role in final visual outcome? BMJ Open. 2011;1(1):e000060–e000060.
19. Zhang YT, Du LQ, Liu M, Zhu J. Spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury: A case report. BMC Ophthalmol. 2020;20(1):4–7.
20. Rofagha S, Day S, Winn BJ, Ou JI, Bhisitkul RB, Chiu CS. Spontaneous resolution of a traumatic cataract caused by an intralenticular foreign body. J Cataract Refract Surg. 2008;34(6):1033–5.
21. Stamper RL, Lieberman MF, Drako MV. Secondary Open-Angle Glaucoma. In: Becker-Shaffer's diagnosis and therapy of the glaucoma. 8th ed. St. Louis: Mosby, 2009; p. 271-3.
22. How to Spot Retained Lens Fragments [Internet]. CollaborativeEYE. 2020 [cited 16 November 2020]. Available from: https://collaborativeeye.com/articles/2019-oct/how-to-spot-retained-lens-fragments/
23. Asaria R, Wong S, Sullivan P. Risk for posterior capsule rupture after vitreoretinal surgery. Journal of Cataract & Refractive Surgery. 2006;32: 1068-1069.
24. Stamper RL, Lieberman MF, Drako MV. Secondary Angle-Closure Glaucoma. In: Becker-Shaffer's diagnosis and therapy of the glaucoma. 8th ed. St. Louis: Mosby, 2009; p. 212-6.
25. Jeong Y, Hwang Y. Etiology and Features of Eyes with Rubeosis Iridis among Korean Patients: A Population-Based Single Center Study. PLOS ONE. 2016;11: e0160662.