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Impressum
Obscure ocular pain and irritation after cataract extraction
Schmack I., Auffarth G. U., Krastel H., Völcker H. E.
Universitäts-Augenklinik Heidelberg, INF 400, 69120 Heidelberg
A 60-year old woman complained about persistant ocular pain and irritation
of the right eye four weeks after external cataract extraction with implantation
of an IOL (Allergan SI40 NB). At the first presentation we found a marked
inflammatory reaction in the anterior chamber with circular conjunctival
hyperemia. The best corrected vision was 20/50, IOP was 14 mm hg. Postulating
an allergic reaction we tried to treat her for 14 days with preservative
free local antiinfammatory medication. As differential diagnosis we discussed
an UGH-syndrome with dislocation of one lens haptic. An exact localisation
of the haptic was not possible because of an insufficient pupil dilation.
We were only able to dilate the pupil by ¼ of the initial diameter.
After an intensive therapy with antiinflammatory eyedrops, especially
with serum eyedrops due to a painful sicca-syndrome, the symptoms decreased.
Then a maximum mydriasis could be achieved and we found a zonula lesion
with an adhesion of a pigmented vitreous-string at the lower anterior
capsulorhexis margin. Within one week after synechiolysis of the vitreous-string
by Nd:YAG-Laser all symptoms were gone and the vision increased up to
20/20.