Bubble behind the iris: What do we do?

A 32-year-old male with a prior history of Implantable Collamer Lens (ICL) surgery presented with corneal decompensation, and underwent Descemet Stripping Endothelial Keratoplasty (DSEK).
On post-operative day one, he had a shallow anterior chamber, the air bubble was hardly present but the DSEK graft was well attached
His digital pressure was hard. Slit-lamp examination revealed posterior migration of the air bubble behind the iris, resulting in AC shallowing through a reverse pupillary block–like mechanism rather than true overfill
We tried dilating the pupil to move the air bubble anteriorly but after that didn't work. we managed with controlled burping of the air bubble

This worked well with the AC deepening immediately, and patient had immediate relief from pain


www.ophthalmobytes.com
Image from Rajan Eye Care Hospital⁣

#ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #ophthalmologist #medicaleducation #ophthalmologyresident #ophthalmologyresidency #apaoyo #dsek #endothelialkeratoplasty #cornealgraft #keratoplasty #cornea #asoct #pupillaryblock