A Case of Uveitis-Hyphema-Glaucoma Syndrome Due to EX-PRESS Glaucoma Filtration Device Implantation. Issue 10 (October 2019)

• Record Type: Journal Article
• Authors: Hou, Andrew; Hasbrook, Madeleine; Crandall, David
• Is Part Of: Journal of glaucoma. Volume 28:Issue 10(2019)
• Publication Date: 2019-10
• Subjects: glaucoma drainage device -- uveitis-glaucoma-hyphema -- laser iridoplasty -- EX-PRESS shunt; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000001327
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Purpose: To report a case of a 69-year-old patient who developed uveitis-glaucoma-hyphema syndrome (UGH) after an uneventful EX-PRESS mini shunt surgery for advanced primary open-angle glaucoma and to discuss management options and clinical implications. UGH syndrome is a rare, but serious complication usually described after cataract surgery. It is often described in anterior chamber intraocular lenses, sulcus lenses, and malpositioned or subluxed lenses resulting in chafing of the lens-iris interface. Clinical manifestations include increased intraocular pressure, anterior chamber inflammation, and recurrent hyphema. Patient and Methods: We report a case of a 69-year-old African American man who developed UGH syndrome 8 years after uneventful implantation of a P-50 EX-PRESS miniature shunt. Slit-lamp examination demonstrated persistent inflammation without evidence of iris atrophy nor intraocular lens dislocation; however, gonioscopy demonstrated localized iris atrophy under the shunt with surrounding iris billowing and a layered hyphema. Results: A localized laser iridoplasty around the shunt was performed leading to resolution of uveitis and hyphema. No other complications occurred during follow-up. Conclusions: Given the increasing acceptance of glaucoma procedures involving implants, UGH syndrome may become more prevalent as new sources of intraocular devices may cause potential complications. Laser iridoplasty provides a minimally invasive approach to treating a localized source of chafing and reduce further surgical intervention.