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A Case of Uveitis-Hyphema-Glaucoma Syndrome Due to EX-PRESS Glaucoma Filtration Device Implantation

Hou, Andrew MD; Hasbrook, Madeleine MD; Crandall, David MD

doi: 10.1097/IJG.0000000000001327
Online Articles: Case Report/Small Case Series
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Purpose: 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.

Patient and Methods: 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.

Results: A localized laser iridoplasty around the shunt was performed leading to resolution of uveitis and hyphema. No other complications occurred during follow-up.

Conclusions: 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: ahou1@hfhs.org).

Received May 17, 2019

Accepted July 1, 2019

Online date: July 12, 2019

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