[Treatment of uveal effusion syndrome after filtering surgery (2 case reports)].
The purpose of this article is to report the surgical treatment of two patients. After the filtering surgery a dehiscence of the conjunctiva emerged and was followed by an extreme hypotony of the eyeball and an extensive uveal effusion. The first patient, 82 years old lady, was treated with the diagnosis of chronic open angle glaucoma for 25 years. The right eye with an absolute glaucoma, the left eye had normal intraocular pressure (IOP) and was after a combined filtering surgical procedure with phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in 1998. In autumn 2000, the patient suffered conjunctivitis, and the prominent filtering bleb was damaged due to frequent rubbing of the eye because of itching. Severe hypotony of the eyeball with secondary uveal effusion followed. Considering the age of the patient and the only functional eye, an extreme surgery was indicated: PC IOL explantation (removal), pars plana vitrectomy (ppV) with silicone oil implantation. After the surgery the eyeball was anatomically stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.08 (1/12 or 3/36) and certain light perception. The second patient, 35 years old man suffered in 1995 a serious penetrating injury with an intraocular foreign body of the right globe. During the following five years the patient underwent in altogether six intraocular surgeries due to posttraumatic cataract and rhegmatogenous and tractional detachment of the retina. In the year 2000, trabeculectomy due to secondary glaucoma was indicated and 8 months later, on patients demand an anterior chamber intraocular lens (AC IOL) was implanted. During the first week after the surgery severe hypotonia of the globe and secondary uveal effusion caused by conjunctival dehiscence in the upper nasal quadrant of the eyeball developed. Because of complicated ocular history of the patient who underwent on the whole eight eye surgeries a relative minimal procedure was indicated: AC IOL removal and insufflation of 1 ml of 100% hexafluorosulfide (SF6) expansive gas into the anterior chamber and vitreous cavity. The globe was stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.25 (6/24 or 20/80) with certain light perception.
Pesáková
M
M
Ocní klinika VFN a 1. LF UK, Praha. pesakova.m@seznam.cz
Dotrelová
D
D
Kuthan
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013577:Syndrome; D014603:Uveal Diseases / Q000209:etiology / Q000601:surgery*