Causes of High Intraocular Pressure after Phaco Surgery

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Female pt. with 55 yrs old not diabetic or hypertensive had underwent uneventeful phaco with foldable IOL then IOP (Intraocular Pressure) was normal for one week & then after one week become 50 mmhg & pt. is on cosopt 2 times / day & cidamex tab. 4 times / day & AC is of normal depth With corneal oedema & VA is HM & IOP no responding to medical treatment.
I want to know the cause & the treatment of this high IOP after one week from the operation.





Thanks for your Question
Sometimes, the viscoelastic material can be trapped behind the intraocular lens and with time, this material can have access to the anterior chamber. In this case, high intraocular pressure that is unresponded to anti-glaucoma medication.
Another common thing is malignant glaucoma which can occur after any kind of intraocular surgery. Anterior chamber should be shallow and the anterior chamber in your case is normal in size.
Gonioscopy in patient with corneal edema can be difficult, i would prefer to use UBM scan of the anterior chamber to visualize the angle to rule out peripheral anterior synechia which sometimes can occur with severe inflammation after surgery or the patient might have plateau iris glaucoma with deep central anterior chamber but closed peripheral angle.
Web Eye Clinic

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