Anterior segment ischemia following pterygium surgery |
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| Affiliation: | 1. Department of Biotechnology, School of Life Sciences, Karpagam University, Eachanari Post, Coimbatore 641021, Tamil Nadu, India;2. Department of Chemistry, Government Arts College, Udumalpet 642126, Tamil Nadu, India;1. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA;2. Department of Bioengineering, University of Washington, Seattle, Washington, USA;3. Research and Development, Carl Zeiss Meditec, Inc, Dublin, California, USA;1. The Eye Center, Eugene, Oregon, and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon;2. Ophthalmic Consultants of Boston, Boston, Massachusetts;3. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida and Miami Veterans Affairs Healthcare System, Miami, Florida;4. Stein Eye Institute, Los Angeles, California;5. Glaucoma Center of San Francisco, Glaucoma Research and Education Group, San Francisco, California;6. Harvard Medical School, Department of Ophthalmology, Massachusetts Eye & Ear, Glaucoma Service, Boston, Massachusetts;1. Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts;2. Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts;3. New England Eye Center, Tufts University Medical Center, Boston, Massachusetts;4. Praevium Research Inc., Santa Barbara, California;5. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida |
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| Abstract: | A 60-year-old woman developed anterior segment ischemia 1 week after an uneventful pterygium excision in the left eye. Corrected visual acuity fell from 20/20 to 20/200. Ophthalmic examination found keratic precipitates on the corneal endothelium, ++ cells in the aqueous humor, and necrosis of the lower half of the iris with posterior synechiae resulting in a fixed and distorted pupil. On therapy of topical corticosteroid eyedrops hourly and atropine eyedrops three times a day, the iridocyclitis resolved in 2 weeks. At the final examination 3 months after the surgery, the corrected visual acuity was 20/20. The atrophy of the lower half of the iris and posterior synechiae in the lower half of the pupil, giving the fixed and distorted pupil, were noted as sequelae. Iris fluorescein angiography revealed filling defects in the lower half of the iris but no leakage from iris vessels. Systemic evaluation was unremarkable except for mild hypertension. Doppler studies of carotid, ophthalmic, and central retinal arteries were normal. Mitomycin C, β-irradiation and rectus muscle fixation sutures were not used. Only conjunctival dissection or episcleral cauterization were seen as possible causes of interference with the anterior segment blood supply. We believe this is the first report of anterior segment ischemia following pterygium surgery. |
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