Chapter 4-page 2
PHACOANAPHYLACTOID AND PHACOLYTIC REACTIONS
Acute traumatic lens injury may result in a release of lens protein followed by a suppurative and granulomatous inflammatory response (Figure 4-11). Cytologically, the macrophages show ingested lens material (Figure 4-12) [
12]. Macrophages may obstruct the trabecular meshwork and produce elevated intraocular pressure (phacoanaphylactic glaucoma) [
13]. In hypermature cataracts, lens protein may leak through the capsule without evidence of trauma and produce a macrophage inflammatory response that may obstruct the trabecular meshwork (phacolytic glaucoma) [
14]. In addition, soluble lens proteins can obstruct aqueous outflow pathways and may be a factor in both of these lens-related glaucomas [
15].
REFERENCE
12. Goldberg MF. Cytological diagnosis of phacolytic glaucoma utilizing Millipore filtration of the aqueous. Br J Ophthalmol 1967;51:847.
13. Yanoff M, Scheie HG. Cytology of human lens aspirate. Arch Ophthalmol 1968;80:166-170.
14. Flocks M, Littwin CS, Zimmerman LE. Phacolytic glaucoma. Arch Ophthalmol 1955;54:37-45.
15. Epstein DL, Jedziniak JA, Grant MW. Obstruction of aqueous outflow by lens particles and by heavy molecular weight soluble lens protein. Invest Ophthalmol Vis Sci 1978;17:272-277.
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