Malick Huzaifa, Wilde Craig, Stead Richard E
University Hospitals of Leicester, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, 03003031573, United Kingdom.
Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom.
Int J Ophthalmol. 2023 Apr 18;16(4):652-655. doi: 10.18240/ijo.2023.04.21. eCollection 2023.
To describe a case of aqueous misdirection complicated by subsequent persistent choroidal effusions following implantation of a Preserflo MicroShunt (PMS) device to treat advanced closed angle glaucoma.
A 67-year-old caucasian female with advanced primary angle-closure glaucoma on four medications with an intraocular pressure (IOP) of 26 mm Hg was listed for a PMS insertion with mitomycin C (MMC).
Past ocular history was significant for pseudophakia and previous yttrium aluminum garnet (YAG) peripheral iridotomy. Surgery was uneventful but on the first postoperative day, she developed aqueous misdirection complicated by subsequent development of persistent uveal effusions. Conventional treatment strategies including atropine drops, YAG hyaloidotomy and choroidal effusion drainage proved ineffective. A combination of oral steroids and pars plana vitrectomy (PPV) along with an irido-zonulo-hyloidectomy (IZH) proved efficacious.
To the best of the author's knowledge, this is the first published case of aqueous misdirection complicated with the presence of significant, unresolving choroidal effusions, highlighting the possibility and sequelae of comorbid pathology in nanophthalmic eyes.
描述一例在植入Preserflo微型分流器（PMS）治疗晚期闭角型青光眼后发生房水错流并伴有持续性脉络膜积液的病例。
一名67岁患有晚期原发性闭角型青光眼的白种女性，正在使用四种药物治疗，眼压（IOP）为26 mmHg，计划接受PMS植入并联合丝裂霉素C（MMC）治疗。
既往眼部病史包括人工晶状体植入和既往钇铝石榴石（YAG）周边虹膜切开术。手术过程顺利，但术后第一天，她出现了房水错流，并随后出现了持续性葡萄膜积液。包括阿托品滴眼液、YAG玻璃体切割术和脉络膜积液引流在内的传统治疗策略均无效。口服类固醇、玻璃体切除术（PPV）联合虹膜-悬韧带-玻璃体切除术（IZH）的联合治疗被证明是有效的。
据作者所知，这是首例发表的房水错流合并严重且持续不消退的脉络膜积液的病例，突出了小眼球合并病理状况的可能性和后遗症。
