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Case Reports
. 2015 Aug;94(31):e1248.
doi: 10.1097/MD.0000000000001248.

Surgical Management in a Patient With Complex Uveitic Glaucoma: A Case Report

Zhu Huang  1 , Xiao-Yu Wang, Wei Han
Affiliations
Case Reports

Surgical Management in a Patient With Complex Uveitic Glaucoma: A Case Report

Zhu Huang et al. Medicine (Baltimore). 2015 Aug.

Abstract

Uveitic glaucoma (UG) is secondary glaucoma, present as a clinical challenge in both diagnosis and management.We report a case of complex UG, which initially presented as pupillary block and rupture of the anterior lens capsule. We performed cataract extraction with preservation of posterior capsule. Then, the case turned to aphakic malignant glaucoma. We performed anterior vitrectomy with posterior capsule resection in this case. After the second operation, the patient had a satisfactory recovery. Specifically, ultrasonographic biomicroscopy was useful during the diagnosis process and follow-up period in this case.UG presenting as pupillary block, rupture of the anterior lens capsule, and aqueous misdirection seldom presents in clinical practice. Earlier and more active surgical intervention may be necessary for effective preservation of visual function in complex cases of UG.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Ultrasonographic biomicroscopy (UBM) image of the left eye shows massive fibrin in the anterior and posterior chambers (white arrow and yellow arrow), shallowing of the anterior chamber, and iris bombe (red arrow). The ciliary body is not well visualized because of the severe inflammatory reaction.
FIGURE 2
FIGURE 2
Slit-lamp examination image shows rupture of the anterior lens capsule in the pupil area, migration of the lens cortex into the anterior chamber, and almost complete absence of the anterior chamber.
FIGURE 3
FIGURE 3
UBM image (A) obtained 25 days after cataract extraction (CE) surgery in the left eye shows fibrin in the anterior chamber, and shallowing of the anterior and posterior chamber (green arrow show shallow central anterior chamber, red arrow show posterior capsule); and image (B) shows forward rotation of the ciliary body.
FIGURE 4
FIGURE 4
UBM image obtained 1 week after the second surgery comprising anterior vitrectomy and posterior capsule resection shows deepening of the anterior chamber and residual triamcinolone acetonide powder (white arrow) in the anterior chamber angle.
FIGURE 5
FIGURE 5
Slit-lamp examination image obtained 1 week after the second surgery comprising anterior vitrectomy and posterior capsule resection shows deepening of the anterior chamber and residual triamcinolone acetonide powder (white arrow) in the anterior chamber angle.
See this image and copyright information in PMC

References

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