Citation:Elhusseiny AM, Lee RK, Smiddy WE. Surgical management of uveitis-glaucoma-hyphema syndrome. Int J Ophthalmol 2020;13(6):935-940,doi:10.18240/ijo.2020.06.12
Surgical management of uveitis-glaucoma-hyphema syndrome
Received:January 14, 2020  Revised:February 18, 2020
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DOI:10.18240/ijo.2020.06.12
Key Words:intraocular lens complications  secondary glaucoma  vitrectomy
Fund Project:The Bascom Palmer Eye Institute is supported by NIH Center Core (No.P30EY014801); a Research to Prevent Blindness Unrestricted Grant; Lee RK is supported by the Walter G. Ross Foundation.
        
AuthorInstitution
Abdelrahman M. Elhusseiny Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Ophthalmology, Kasr Al-AinySchool of Medicine, Cairo University, Cairo 12611, Egypt
Richard K. Lee Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
William E. Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Abstract:
      AIM: To report outcomes of patients after intraocular lens (IOL) repositioning or exchange for the version of the uveitis-glaucoma-hyphema (UGH) syndrome that does not include closed loop anterior chamber IOL (nUGH).

    METHODS: Chart review of patients with nUGH who underwent IOL repositioning or exchange by one surgeon were reviewed. The main outcome measures were best corrected visual acuity (BCVA) as a decimal fraction preoperatively and postoperatively after IOL repositioning or exchange. Clinical findings evaluated included the presence of uveitis, hyphema, elevated intraocular pressure (IOP), and other complications such as pigment dispersion or vitreous hemorrhage. The number of anti-inflammatory and glaucoma medications were assessed before and after IOL repositioning or exchange.

    RESULTS: The study included 14 pseudophakic eyes. The median time at the onset of contemporary UGH after cataract extraction and IOL implantation (CE/IOL) was 7.5y. IOL repositioning or exchange was performed at a mean duration of 8.1±4.7mo (median: 4mo) after onset of UGH. The mean BCVA was improved from 0.45±0.26 preoperatively after onset of UGH syndrome to 0.76±0.22 (P=0.016) after IOL repositioning or exchange. Among the 14 eyes, uveitis, elevated IOP, and hyphema were present preoperatively in 13, 13, and 6 eyes, respectively. Uveitis and hyphema resolved in all cases after IOL surgery. The mean IOP was reduced from 26.4±4.5 mm Hg preoperatively to 14.7±4.9 postoperatively (P=0.01). The mean number of glaucoma medications used was reduced from 1.7±1.1 medications preoperatively to 0.8±1.08 (P=0.04) postoperatively.

    CONCLUSION: IOL repositioning or exchange is an effective treatment in many cases for medically resistant contemporary UGH syndrome.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270258/
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