To report a case of a 69-year-old patient who developed uveitis-glaucoma-hyphema syndrome (UGH) after an uneventful EX-PRESS mini shunt surgery for advanced primary open-angle glaucoma and to discuss management options and clinical implications. UGH syndrome is a rare, but serious complication usually described after cataract surgery. It is often described in anterior chamber intraocular lenses, sulcus lenses, and malpositioned or subluxed lenses resulting in chafing of the lens-iris interface. Clinical manifestations include increased intraocular pressure, anterior chamber inflammation, and recurrent hyphema.
We report a case of a 69-year-old African American man who developed UGH syndrome 8 years after uneventful implantation of a P-50 EX-PRESS miniature shunt. Slit-lamp examination demonstrated persistent inflammation without evidence of iris atrophy nor intraocular lens dislocation; however, gonioscopy demonstrated localized iris atrophy under the shunt with surrounding iris billowing and a layered hyphema.
A localized laser iridoplasty around the shunt was performed leading to resolution of uveitis and hyphema. No other complications occurred during follow-up.
Given the increasing acceptance of glaucoma procedures involving implants, UGH syndrome may become more prevalent as new sources of intraocular devices may cause potential complications. Laser iridoplasty provides a minimally invasive approach to treating a localized source of chafing and reduce further surgical intervention.
Department of Ophthalmology, Henry Ford Hospital, Detroit, MI
Disclosure: The authors declare no conflict of interest.
Reprints: Andrew Hou, MD, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48072 (e-mail: firstname.lastname@example.org).
Received May 17, 2019
Accepted July 1, 2019
Online date: July 12, 2019