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Delayed-Onset, Recurrent Hyphema after Microhook ab interno Trabeculotomy.

Masaki Tanito¹

¹Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan.

Case Reports in Ophthalmology

|February 22, 2021

Summary

This summary is machine-generated.

Delayed hyphema occurred in an incisional trabeculotomy (LOT) case. This suggests Schlemm

Keywords:

Delayed-onset hyphema Microhook ab interno trabeculotomy Minimally invasive glaucoma surgery Surgical complication

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Area of Science:

Ophthalmology
Glaucoma Surgery
Anterior Segment Surgery

Background:

Trabeculotomy (LOT) and goniotomy surgeries are classified by trabecular meshwork excision or incision.
Excisional LOT previously correlated with blood reflux from Schlemm's canal (SC).
Delayed hyphema after incisional LOT is uncommon.

Observation:

An 87-year-old woman with normal-tension glaucoma presented with delayed hyphema in her right eye.
The patient had undergone microhook ab interno LOT (μLOT) and cataract surgery 4 years prior.
Examination revealed angle hyphema and an open LOT cleft, with no other identifiable cause.

Findings:

This case presents delayed-onset hyphema following incisional LOT (μLOT).
Schlemm's canal remained open years after the incisional procedure.
The findings challenge previous assumptions about SC healing after excisional versus incisional LOT.

Implications:

Incisional LOT may result in long-standing patency of Schlemm's canal.
This suggests a potential mechanism for delayed hyphema in glaucoma patients.
Further research is needed to understand the long-term effects of incisional glaucoma surgeries.