Transcleral posterior chamber paracentesis for angle closure glaucoma secondary to posterior chamber gas entrapment after intravitreal c3f8 injection in a phakic eye

Retin Cases Brief Rep. 2012 Summer;6(3):263-5. doi: 10.1097/ICB.0b013e3182247827.

Abstract

Purpose: The purpose of this study was to describe a new technique for treating a case of angle closure glaucoma secondary to posterior chamber (PC) gas entrapment after intravitreal C3F8 injection.

Methods: Retrospective case report.

Results: A 26-year-old woman received intravitreal injection of 0.4 mL of C3F8 after segmental scleral buckling for retinal detachment of her phakic eye. Prone positioning was not maintained postoperatively, and severe eye pain developed within hours of surgery. Intraocular pressure increased to 50 mmHg, and PC was found to be filled with gas accompanying with 360° iridocorneal apposition and angle closure. Transcleral PC paracentesis was performed to evacuate the gas. Anterior chamber angle was reopened inferiorly, and intraocular pressure dropped to 13 mmHg immediately and remained normal. No evidence of lens or iris damage was noted. Postoperatively, the vision improved to 20/25 without major sequelae.

Conclusion: Posterior chamber gas entrapment with anterior chamber collapse is a rare complication of intravitreal gas injection in phakic eyes. Transcleral PC paracentesis is a safe way to treat angle closure glaucoma secondary to PC gas entrapment.