title: Pars plana anterior vitrectomy, hyaloido-zonulectomy, and iridectomy for aqueous humor misdirection.
abstract: OBJECTIVE
  To report a surgical technique for aqueous misdirection refractory to medical treatment consisting of combined pars plana vitrectomy, hyaloido-zonulectomy, and peripheral iridectomy.
  
  
  METHODS
  Noncomparative case series.
  
  
  METHODS
  The charts of 5 pseudophakic patients who sought treatment for aqueous humor misdirection refractory to medical treatment from May 2008 trough February 2009 were reviewed. All 5 patients underwent anterior vitrectomy, hyaloido-zonulectomy, and peripheral iridectomy with an anterior vitrector through a pars plana incision. Main outcome measures were preoperative and postoperative visual acuity, intraocular pressure, medications, slit-lamp examination results, and fundus findings.
  
  
  RESULTS
  Five female patients (age range, 23 to 89 years) had increased intraocular pressure and shallowing of the anterior chamber after cataract extraction or trabeculectomy, and none responded to conventional medical therapy. After surgery, prompt resolution of the aqueous misdirection was achieved in all cases. The follow-up was 7.6 months (range, 1 to 13 months).
  
  
  CONCLUSIONS
  Aqueous misdirection refractory to medical treatment can be treated successfully with surgery consisting of partial pars plana vitrectomy, hyaloido-zonulectomy, and peripheral iridectomy.
authors.affiliation: Jules Stein Eye Institute, University of California Los Angeles, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Bitrian
authors.forename: Joseph
authors.initials: J
authors.lastname: Caprioli
mesh_terms: D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D001082:Aqueous Humor / Q000378:metabolism*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D018918:Phacoemulsification / Q000009:adverse effects; D014130:Trabeculectomy / Q000009:adverse effects; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery*; D055815:Young Adult