ANTERIOR SEGMENT ISCHEMIA FOLLOWING PTERYGIUM SURGERY

A 60-year-old woman developed anterior segment ischemia 1 week after a n uneventful pterygium excision in the left eye. Corrected visual acui ty fell from 20/20 to 20/100, Ophthalmic examination found keratic pre cipitates on the corneal endothelium, + + cells in the aqueous humor, and necrosis of the lower half of the iris with posterior synechiae re sulting in a fixed and distorted pupil. On therapy of topical corticos teroid eyedrops hourly and atropine eyedrops three times a day, the ir idocyclitis resolved in 2 weeks. At the final examination 3 months aft er 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 o f the pupil, giving the fixed and distorted pupil, were noted as seque lae. Iris fluorescein angiography revealed filling defects in the lowe r half of the iris but no leakage from iris vessels. Systemic evaluati on was unremarkable except for mild hypertension. Doppler studies of c arotid, ophthalmic. and central retinal arteries were normal. Mitomyci n C, beta-irradiation and rectus muscle fixation sutures were not used . Only conjunctival dissection or episcleral cauterization were seen a s possible causes of interference with the anterior segment blood supp ly. We believe this is the first report of anterior segment ischemia f ollowing pterygium surgery. (C) 1997 Japanese Ophthalmological Society .