Targeted Management of Uveitis-Glaucoma-Hyphema Syndrome by Selective Haptic Removal: A Case Report

Area of Science:

• Ophthalmology
• Surgical Innovation
• Intraocular Lens Technology

Background:

• Uveitis-Glaucoma-Hyphema (UGH) syndrome is often associated with intraocular lens (IOL) complications.
• Vertically misaligned IOL haptics can cause UGH syndrome, sometimes escaping detection due to poor pupil dilation.
• Prompt diagnosis and management are crucial for preserving visual function.

Purpose of the Study:

• To detail the intraoperative diagnosis and surgical strategy for UGH syndrome caused by a previously undetected, vertically misaligned IOL haptic.
• To evaluate the efficacy of targeted haptic removal versus complete IOL exchange in managing such cases.

Main Methods:

• Retrospective review of clinical records, surgical notes, and intra-operative videos.
• Literature search for comparable cases of UGH syndrome secondary to IOL malposition.
• Intraoperative anterior segment exploration under challenging mydriasis conditions.

Main Results:

• A case of UGH syndrome in an 86-year-old male was successfully managed by removing a dislocated IOL haptic, preserving the well-centered IOL optic.
• The patient experienced improved visual acuity and normalized intraocular pressure post-operatively, with resolution of hemorrhages and inflammation.
• This approach avoided complete IOL exchange, demonstrating a less invasive surgical option.

Conclusions:

• Complete IOL exchange is not always necessary for UGH syndrome when the IOL optic is centered and the capsular bag is intact.
• Targeted removal of the offending IOL haptic can effectively resolve UGH syndrome by eliminating iris-IOL contact.
• This highlights a conservative surgical approach for specific UGH syndrome presentations.