Acute angle-closure glaucoma after total knee replacement surgery: case report and literature review

Abstract

An early and correct diagnosis improves the prognosis of post-operative Acute Angle Closure Glaucoma (AACG). A 65 years-old monophtalmus man was operated for a total knee replacement surgery, under general anaesthesia without any adverse events. The day after, the patient described recurrent periorbital pain in his eye, with ocular hyperaemia, and reduced visual acuity. A diagnosis of AACG was made and conservative treatment was started to reduce the intraocular pressure. In the post operative AACG, several predisposing local factors including genetic predisposition, female gender, hypermetropia, increased lens thickness and small corneal diameter, can be added to a pupillary block induced by adrenergic and anticholinergic drugs used in anaesthetic procedures as risk factors. An acute and intensive periorbital or ocular pain, with or without visual disturbance, must aware the physician.