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Iatrogenic Lens Trauma-induced Glaucoma Following Pars Plana Vitrectomy

Purpose: To report a case of iatrogenic lens-trauma-induced glaucoma with pseudohypopyon after pars plana vitrectomy, which is a rare presentation that is often confused with postoperative endophthalmitis. Case summary: A 63-year-old male presented with uncontrolled intraocular pressure with suspected postoperative endophthalmitis in the right eye. The intraocular pressure was 50 mmHg, and slit-lamp examination revealed inflammatory cells, multiple iridescent crystalline materials in the anterior chamber, and a blood-tinged pseudohypopyon, resulting in a diagnosis of iatrogenic lens-induced glaucoma secondary to posterior capsular break during pars plana vitrectomy. Phacoemulsification, pars plana lensectomy with vitrectomy, and intraocular lens implantation in the sulcus using the optic capture technique were performed. Intraoperatively, a linear posterior capsular break was identified as expected. One month postoperatively, the patient’s visual acuity improved to 20/20, and the intraocular pressure was 8 mmHg without any medication. Conclusions: Iatrogenic crystalline lens damage during pars plana vitrectomy can induce glaucoma, which can be confused with postoperative endophthalmitis owing to the presence of a pseudohypopyon, and the two diseases should be differentiated from each other.