[Ultrasonic decompression of malignant ocular hypertension secondary to traumatic hyphema]

The prognosis of traumatic hyphemias in general is favorable, the blood being resorbed spontaneously in a short period. The case is different, however, where hemorrhage is abundant, and the condensed blood in the anterior chamber coagulates; here, the angle is often blocked with fibrin, the intraocular pressure rises considerably, accompanied always with severe pain. The arrest of aqueous circulation by the consolidated clot suppresses the process of resorption; thereafter, local and general therapeutic measures become ineffective. The state of "malignant hypertension" once established, surgical intervention becomes imperative. In this study are given the results of 10 cases of traumatic hyphemia complicated by malignant hypertension, treated by ultrasonic irradiation. The results are obviously favorable: rapid fall of ocular hypertension with prompt disappearance of subjective symptoms; revelation of signs of liquefaction and resumption of processes of resorption in 9 patients. Under continued treatment, complete resorption of the hyphemia was attained with accelerated pace. In one case, however, unrelenting hypertension persisted to the 12th day, despite the complete liquefaction of the coagulum. A phakotopic factor lying under the hyphemia was suspected. The visual recuperation was remarkable in 7 cases free from posterior segment alterations.