Clinical Analysis of 50 Chinese Patients with Aqueous Misdirection Syndrome: a Retrospective Hospital-based Study
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1Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Objectives:
To evaluate the efficacy of treatments for aqueous misdirection syndrome and explore possible risk factors influencing prognosis.
Methods:
Data including demographics, initial clinical characteristics and ocular outcomes at follow-up were collected for patients treated for aqueous misdirection syndrome. Main outcome measures were: best-corrected visual acuity (BCVA); intraocular pressure (IOP); number of antiglaucoma medications; recurrence; complications.
Results:
Data were available for 50 patients (57 eyes). Final mean BCVA improved significantly and correlated with baseline BCVA (mean follow-up, 34.47±28.65 months). Final mean IOP and mean number of antiglaucoma medications were significantly reduced. Treatment failure rates were higher in patients with significantly higher IOP at baseline and/or shorter axial length. Following pars plana vitrectomy (PPV), recurrence occurred in two of 10 pseudophakic and one of 40 phakic eyes; complications were observed in 12/50 eyes (choroidal detachment, corneal decompensation, retinal detachment, vitreous haemorrhage, hyphaema).
Conclusions:
PPV and laser treatments, augmented by pharmacotherapy, were effective in treating aqueous misdirection syndrome. Surgical intervention should be undertaken early in eyes with higher baseline IOP and/or shorter axial length. Total vitrectomy-zonulectomy-iridectomy is a potential approach for recalcitrant cases.
