title: Gonioaspiration for refractory glaucoma secondary to traumatic hyphema in patients with sickle cell trait.
abstract: The authors describe a new surgical method for treating disproportionately high intraocular pressures secondary to small traumatic hyphemas in three patients with the sickle cell trait. A novel technique was performed in all three cases to clear the hyphema from the anterior chamber angle. A Lewicky anterior chamber maintainer cannula was placed at the superior limbus to maintain infusion into the anterior chamber. Under direct visualization using a Koeppe goniotomy lens, a 23-gauge single-port cannula was used to aspirate the hyphema from the anterior chamber angle until it was free of blood. There were no intraoperative complications. Measurements of intraocular pressure were normal 2 hours after the procedure and at every subsequent visit. There was an improvement in visual acuity to 6/9 or better in all three of the cases. Therefore, gonioaspiration is an effective treatment of persistently raised intraocular pressures in patients with sickle cell trait.
authors.affiliation: Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom.
authors.forename: Pravin
authors.initials: P
authors.lastname: Pandey
authors.forename: Velota C T
authors.initials: VC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D002648:Child; D005131:Eye Injuries / Q000150:complications*; D018463:Filtering Surgery / Q000379:methods*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006988:Hyphema / Q000150:complications*; D007429:Intraocular Pressure; D008297:Male; D012805:Sickle Cell Trait / Q000150:complications*; D013396:Suction / Q000379:methods; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult