Infusion misdirection syndrome during trabeculectomy for primary trabeculodysgenesis.
OBJECTIVE
To report a case of infusion misdirection syndrome, simulating an intraoperative suprachoroidal hemorrhage, in an eye undergoing trabeculectomy for primary trabeculodysgenesis.


METHODS
A 21-year-old woman underwent trabeculectomy for primary trabeculodysgenesis. Congenitally abnormal intraocular anatomy led to intraoperative and postoperative complications.


RESULTS
Intraoperative anterior chamber irrigation was followed by vitreous prolapse. Eye pain, globe hardening, and shallowing of the anterior chamber were caused by infusion misdirection into the posterior segment. The eye was rapidly closed after a limited wound-site vitrectomy. Intraoperative and postoperative management led to a successful outcome.


CONCLUSIONS
Altered intraocular anatomy set the stage for infusion misdirection syndrome, a rare but manageable complication that mimicked an expulsive suprachoroidal hemorrhage.
Realini
Tony
T
Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA. hypotony@yahoo.com
Vaphiades
Michael S
MS
D000328:Adult; D002832:Choroid Hemorrhage / Q000175:diagnosis; D003315:Cornea / Q000002:abnormalities; D005124:Eye Abnormalities / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D007498:Iris / Q000002:abnormalities; D011183:Postoperative Complications; D012599:Sclerostomy; D013577:Syndrome; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D014129:Trabecular Meshwork / Q000002:abnormalities*; D014130:Trabeculectomy; D014792:Visual Acuity