Persistent corneal blood staining after microhook trabeculotomy: A case report
Ryota Aoki1, Shunsuke Nakakura
1Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Medicine
|July 8, 2022
Summary
Massive anterior chamber hemorrhage (hyphema) after glaucoma surgery can lead to corneal bloodstaining and severe vision loss. Prompt recognition and management are crucial for better outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Corneal Diseases
Background:
- Minimally invasive glaucoma surgery (MIGS) can lead to complications like hyphema.
- Hyphema and elevated intraocular pressure (IOP) increase the risk of corneal bloodstaining.
- Steroid use is a known risk factor for glaucoma and elevated IOP.
Observation:
- A 71-year-old female with severe dry eye on fluorometholone drops developed steroid-induced glaucoma with elevated IOP.
- Following microhook trabeculotomy, she experienced hyphema and high IOP, leading to corneal bloodstaining.
- Despite anterior chamber cleaning, significant corneal opacity persisted, resulting in light perception visual acuity.
Findings:
- Corneal bloodstaining following hyphema and elevated IOP can be persistent and severe.
- Complete resolution of corneal bloodstaining may take over a year, with potential for significant visual impairment.
- Early and aggressive management of hyphema and IOP post-MIGS is critical.
Implications:
- This case highlights the potential for severe visual loss due to corneal bloodstaining after MIGS.
- Ophthalmologists must be vigilant for persistent corneal bloodstaining in patients with hyphema and high IOP post-MIGS.
- Further research into preventative and therapeutic strategies for corneal bloodstaining is warranted.
