Successful goniotomy in hemophilia A

Area of Science:

• Ophthalmology
• Pediatric Hematology

Background:

• Congenital glaucoma presents a significant surgical challenge in infants.
• Hemophilia A, a rare bleeding disorder, poses a critical risk during surgical interventions.

Observation:

• An 8-month-old infant with congenital glaucoma and undiagnosed hemophilia A experienced severe hemorrhages post-trabeculotomy, leading to eye loss.
• Hemophilia A was diagnosed only after the initial surgical complication.

Findings:

• A subsequent goniotomy on the fellow eye was successfully performed after normalizing factor VIII activity.
• Long-term follow-up (16 years) showed normal visual fields, excellent visual acuity (1.6), and stable intraocular pressure (18-21 mm Hg).

Implications:

• This case demonstrates the feasibility of successful ophthalmic surgery in children with hemophilia A.
• Pre-operative screening for hemophilia A is essential in pediatric patients undergoing ophthalmic procedures to prevent severe complications.