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Aqueous misdirection and flat chamber after posterior chamber implants with and without trabeculectomy
Archives of Ophthalmology (Chicago, Ill. : 1960)
|June 1, 1987
Summary
Aqueous misdirection can occur after glaucoma surgery. Neodymium-YAG laser vitreolysis is a safe, effective first step for managing this complication, often avoiding lens removal.
Area of Science:
- Ophthalmology
- Surgical Complications
- Glaucoma Surgery
Background:
- Aqueous misdirection is a rare but serious complication following intraocular surgery.
- It can occur after combined procedures like trabeculectomy with cataract extraction or lens implantation alone.
Observation:
- Four patients presented with flat anterior chamber, diagnosed as aqueous misdirection.
- One patient developed the condition after lens implantation only, successfully treated with pars plana vitrectomy.
- Three patients developed it after a glaucoma triple procedure (trabeculectomy, cataract extraction, lens implantation).
Findings:
- Two of three patients with the glaucoma triple procedure were treated successfully with neodymium-YAG laser vitreolysis, preserving the posterior capsule.
- One patient required lens removal and anterior vitrectomy.
- The patient with lens implantation alone was cured by pars plana vitrectomy without pseudophakos removal.
Implications:
- Neodymium-YAG laser vitreolysis should be considered the primary treatment for aqueous misdirection due to its safety and efficacy.
- This approach can potentially avoid more invasive surgical interventions, such as lens explantation and anterior vitrectomy.
- Early intervention with minimally invasive techniques can lead to favorable outcomes in managing post-operative aqueous misdirection.