Cataract Eye Surgery
After cataract surgery, air tight chamber is formed at the end of surgery. on 1st post Operation day,patient is having small pupil with air trapped in pupillary area and vision is only Light Perception.
The air didn't get released even with dilatation of pupil and the pt is not having any pain for almost 20hrs.
What to be done to prevent this type of complication? Shall i advise laser iridotomy? what will be the prognosis?
Thanks for the Question
Air in the Anterior Chamber can be absorbed within 24-48 Hours. You have to make sure that there is normal intraocular pressure and the cataract wound is secure with no leakage (Which can cause hypotony and high risk of endophthalmitis) and also you have to make sure that there is no visco-elastic material in the anterior chamber because this can delay the absorption of air and can cause high intraocular pressure.
In case the patient have pain with high intraocular pressure, you can use anti-glaucoma medications to reduce the pressure. If there is visco-elastic material in the anterior chamber and the pressure still high, anterior chamber paracentesis can be done.
Iridotomy can be done for pupillary block in which the anterior chamber is shallow with iris bombe and high intraocular pressure.
You have to differentiate between malignant Glaucoma and Pupillary block because with malignant glaucoma, iridotomy is not useful.