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Case Reports
. 2017 Oct 26;8(3):496-502.
doi: 10.1159/000480726. eCollection 2017 Sep-Dec.

Diagnostic and Therapeutic Approach in a Case of Severe Post-Traumatic Hyphema with Subtotal Iridodialysis

Filippo Romanazzi  1 , Anna Morano  1 , Antonio Caccavale  1
Affiliations
Case Reports

Diagnostic and Therapeutic Approach in a Case of Severe Post-Traumatic Hyphema with Subtotal Iridodialysis

Filippo Romanazzi et al. Case Rep Ophthalmol. .

Abstract

Purpose: To report our diagnostic ultrasound-based approach and surgical strategy in a case of severe blunt trauma with complete hyphema, 270° iris disinsertion, and traumatic subluxated cataract.

Case report: A 70-year-old male was referred to our hospital for a blunt trauma in his right eye. A complete examination revealed visual acuity consisting in light perception, a complete hyphema, and an intraocular pressure of 45 mm Hg with moderate pain. Our diagnostic approached was ultrasound based with B-scan examination showing some vitreous hemorrhage and ultrasound biomicroscopy showing a large iris disinsertion of 270° with the iris entirely dislocated in the inferior sector of the anterior chamber. The patient was hospitalized and a systemic and topical treatment was started to lower intraocular pressure. Our surgery consisted in a single-step approach with removal of traumatic cataract with scleral fixation of an intraocular lens and iridoplasty.

Conclusion: In our patient, the single-step surgery, supported by anterior and posterior ultrasound imaging, achieved a satisfactory anatomical and functional outcome.

Keywords: Hyphema; Iridodialysis; Iridoplasty; Traumatic cataract surgery; Ultrasound; Ultrasound biomicroscopy.

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Figures

Fig. 1.
Fig. 1.
Appearance of the anterior chamber with complete hyphema.
Fig. 2.
Fig. 2.
B-scan examination showing some vitreous hemorrhage.
Fig. 3.
Fig. 3.
Ultrasound biomicroscopy showing large iris disinsertion and hyphema.
Fig. 4.
Fig. 4.
Examination at slit lamp after resolution of hyphema and correspondence with ultrasound biomicroscopy.
Fig. 5.
Fig. 5.
Some surgical phases. Presentation with 270° iridodialysis and subluxated cataract (left, top). Apposition of iris hooks and cataract surgery (right, top). Scleral fixation of an intraocular lens and beginning of iridoplasty (left, bottom). Phases of iridoplasty (right, bottom).
Fig. 6.
Fig. 6.
Anterior segment in the postoperative period at 3 weeks.
See this image and copyright information in PMC

References

    1. Ashaye AO. Traumatic hyphaema: a report of 472 consecutive cases. BMC Ophthalmol. 2008;8:24. - PMC - PubMed
    1. Dessì G, Lahuerta EF, Puce FG, Mendoza LH, Stefanini T, Rosenberg I, Del Prato A, Perinetti M, Villa A. Role of B-scan ocular ultrasound as an adjuvant for the clinical assessment of eyeball diseases: a pictorial essay. J Ultrasound. 2014;18:265–277. - PMC - PubMed
    1. Berinstein DM, Gentile RC, Sidoti PA, Stegman Z, Tello C, Liebmann JM, Ritch R. Ultrasound biomicroscopy in anterior ocular trauma. Ophthalmic Surg Lasers. 1997;28:201–207. - PubMed
    1. Genovesi-Ebert F, Rizzo S, Chiellini S, Romani A, Gabbriellini G, Sartini MS, Nardi M. Ultrasound biomicroscopy in the assessment of penetrating or blunt anterior-chamber trauma. Ophthalmologica. 1998;212((suppl 1)):6–7. - PubMed
    1. Bansal S, Gunasekeran DV, Ang B, Lee J, Khandelwal R, Sullivan P, Agrawal R. Controversies in the pathophysiology and management of hyphema. Surv Ophthalmol. 2016;61:297–308. - PubMed

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