title: Mechanisms for in-the-bag uveitis-glaucoma-hyphema syndrome.
abstract: We propose 2 mechanisms of uveitis-glaucoma-hyphema (UGH) syndrome in 2 patients with intracapsular or in-the-bag single-piece acrylic intraocular lenses (IOLs). In the first case, pseudophacodonesis secondary to zonular laxity from pseudoexfoliation syndrome caused chafing of the posterior iris by the square-edged haptic. In the second case, focal capsular fibrosis around the square-edged haptics combined with anteriorly rotated ciliary processes in plateau iris configuration caused points of chafing. Extensive capsular fibrosis of the haptic in both cases precluded IOL exchange. In the first case, a capsular tension ring redistributed zonular tension and reduced symptoms. In the second case, endoscopic cyclophotocoagulation relieved areas of chafing and resolved symptoms. In-the-bag square-edged haptics of single-piece acrylic IOLs are a potential source of iridociliary chafing in certain situations. The mechanisms observed here should be considered to promptly diagnose and treat UGH.
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Zhang
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Hood
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Vrabec
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Alexis L
authors.initials: AL
authors.lastname: Cullen
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Parrish
authors.affiliation: From the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: smoroi@med.umich.edu.
authors.forename: Sayoko E
authors.initials: SE
authors.lastname: Moroi
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D005131:Eye Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005355:Fibrosis; D005902:Glaucoma, Open-Angle / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D006988:Hyphema / Q000000981:diagnostic imaging / Q000209:etiology*; D007429:Intraocular Pressure; D007498:Iris / Q000000981:diagnostic imaging / Q000293:injuries*; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D033401:Microscopy, Acoustic; D011183:Postoperative Complications; D014606:Uveitis, Anterior / Q000000981:diagnostic imaging / Q000209:etiology*