Spontaneous Clearing of Corneal Blood Staining after Total Hyphema Post a Noncomplicated Ligated Ahmed Glaucoma Valve...

The purpose of this study was to describe a case of total hyphema and corneal blood staining (CBS) after Ahmed implant in a child with aphakic glaucoma.

A 13-year-old girl presented with a history of aphakic glaucoma in the left eye, who was unresponsive to full topical, oral antiglaucoma, and CPC. Child was booked for Ahmed implant with ligation in the left eye. Surgery went smoothly without complication. Day 1 postoperative patient was having dispersed hyphema that increased gradually to reach total hyphema on day 5 with high intraocular pressure reach 48 mmHg. Then, the patient develop CBS. Patient was managed medically with a steroid and a cycloplegic agent in addition to an antiglaucoma as there was a risk of rebleeding with surgical intervention.

Vision-threatening complications are uncommon after Ahmed glaucoma valve (AGV) implantation, although few devastating postoperative complications may occur following the placement of an AGV in pediatric patients requiring further medical or surgical management. The exact mechanism of the bleeding is not clear but most likely from the entry site. Monitoring the patient after the hyphema to assess the need for surgical intervention in case of CBS is mandatory with near follow-up and serial anterior segment photo is advisable to compare between the visits.