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Nonarteritic ischemic optic neuropathy developed after capsular block syndrome.

Hurmeric V, Bayer A, Durukan AH, Mutlu FM - Indian J Ophthalmol (2014)

Bottom Line: After neodymium-doped yttrium aluminum garnet (Nd:YAG) laser anterior capsulotomy, the intraocular pressure remained elevated for 4 days despite antiglaucomatous medication.On the postoperative fifth day, nonarteritic ischemic optic neuropathy was diagnosed.To the best of our knowledge, this is the first report of a case with nonarteritic ischemic optic neuropathy associated with early postoperative capsular block syndrome after phacoemulsification surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

ABSTRACT
A 65-year-old man developed capsular block syndrome in the early postoperative period, following phacoemulsification surgery. After neodymium-doped yttrium aluminum garnet (Nd:YAG) laser anterior capsulotomy, the intraocular pressure remained elevated for 4 days despite antiglaucomatous medication. On the postoperative fifth day, nonarteritic ischemic optic neuropathy was diagnosed. To the best of our knowledge, this is the first report of a case with nonarteritic ischemic optic neuropathy associated with early postoperative capsular block syndrome after phacoemulsification surgery.

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(a) Fundus photography shows nonarteritic ischemic optic neuropathy; (b) fluorescein angiography shows hyperfluorescence of the optic disc
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Figure 2: (a) Fundus photography shows nonarteritic ischemic optic neuropathy; (b) fluorescein angiography shows hyperfluorescence of the optic disc

Mentions: On the postoperative fourth day, IOP was still 30 mmHg and anterior chamber venting was performed with the depression of the posterior lip of the paracentesis incision with a sterile forceps. On the postoperative fifth day, the cornea was clear and there was no capsular bag distention. The refractive error was plano −1.25 × 105 and the IOP was 16 mmHg. The visual acuity was noted to be finger counting from 4 m. Fundoscopic examination revealed optic disc edema and fluorescein angiography showed hyperfluorescence of the optic disc [Fig. 2]. There was prolonged P100 latency in the pattern visual-evoked potentials (Roland Consult RETIscan System, Wiesbaden, Germany). A diagnosis of NAION was made and the patient was given 1000 mg intravenous pulse methylprednisolone per day for 3 days, followed by 64 mg oral prednisolone. Two weeks postoperatively, the visual acuity improved to 20/40. Eighteen months after the surgery, optic disc was pale, visual acuity was 20/40 and there was nasal step in the visual field [Fig. 3].


Nonarteritic ischemic optic neuropathy developed after capsular block syndrome.

Hurmeric V, Bayer A, Durukan AH, Mutlu FM - Indian J Ophthalmol (2014)

(a) Fundus photography shows nonarteritic ischemic optic neuropathy; (b) fluorescein angiography shows hyperfluorescence of the optic disc
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061678&req=5

Figure 2: (a) Fundus photography shows nonarteritic ischemic optic neuropathy; (b) fluorescein angiography shows hyperfluorescence of the optic disc
Mentions: On the postoperative fourth day, IOP was still 30 mmHg and anterior chamber venting was performed with the depression of the posterior lip of the paracentesis incision with a sterile forceps. On the postoperative fifth day, the cornea was clear and there was no capsular bag distention. The refractive error was plano −1.25 × 105 and the IOP was 16 mmHg. The visual acuity was noted to be finger counting from 4 m. Fundoscopic examination revealed optic disc edema and fluorescein angiography showed hyperfluorescence of the optic disc [Fig. 2]. There was prolonged P100 latency in the pattern visual-evoked potentials (Roland Consult RETIscan System, Wiesbaden, Germany). A diagnosis of NAION was made and the patient was given 1000 mg intravenous pulse methylprednisolone per day for 3 days, followed by 64 mg oral prednisolone. Two weeks postoperatively, the visual acuity improved to 20/40. Eighteen months after the surgery, optic disc was pale, visual acuity was 20/40 and there was nasal step in the visual field [Fig. 3].

Bottom Line: After neodymium-doped yttrium aluminum garnet (Nd:YAG) laser anterior capsulotomy, the intraocular pressure remained elevated for 4 days despite antiglaucomatous medication.On the postoperative fifth day, nonarteritic ischemic optic neuropathy was diagnosed.To the best of our knowledge, this is the first report of a case with nonarteritic ischemic optic neuropathy associated with early postoperative capsular block syndrome after phacoemulsification surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

ABSTRACT
A 65-year-old man developed capsular block syndrome in the early postoperative period, following phacoemulsification surgery. After neodymium-doped yttrium aluminum garnet (Nd:YAG) laser anterior capsulotomy, the intraocular pressure remained elevated for 4 days despite antiglaucomatous medication. On the postoperative fifth day, nonarteritic ischemic optic neuropathy was diagnosed. To the best of our knowledge, this is the first report of a case with nonarteritic ischemic optic neuropathy associated with early postoperative capsular block syndrome after phacoemulsification surgery.

Show MeSH
Related in: MedlinePlus