Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Glaucoma Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Eur J Ophthalmol. 2024 Mar;34(2):NP121-NP125. doi: 10.1177/11206721231200063. Epub 2023 Sep 6.
Aqueous misdirection syndrome (AMS) is an aggressive post-operative glaucoma unresponsive to conventional measures with grave outcomes. In this report, we describe a rare case of AMS following silicon oil removal in a vitrectomized eye.
A diabetic patient with tractional retinal detachment underwent pars plana vitrectomy with silicon oil injection. Following retinal reattachment, silicon oil removal was performed at three months. Post oil removal she developed increased intraocular pressure with shallowing of both the peripheral and central anterior chamber suggestive of AMS.
Initial medical management with anti-glaucoma medications and cycloplegics was not beneficial. A pars plana lensectomy with complete anterior hyaloidectomy along with a surgical peripheral iridectomy helped relieve the aqueous misdirection.
AMS can rarely occur following vitrectomy and is likely secondary to intact anterior hyaloid. Lensectomy along with zonulo-hyaloido-iridectomy is essential. This report highlights the occurrence of this rare complication and its effective management.
水性迷路综合征（AMS）是一种术后急性青光眼，对常规治疗措施无反应，后果严重。本报告描述了一例硅油取出术后玻璃体切割眼发生 AMS 的罕见病例。
一名患有牵拉性视网膜脱离的糖尿病患者接受了经睫状体平坦部玻璃体切除术联合硅油注射。视网膜复位后，在三个月时行硅油取出术。取油后，她的眼内压升高，周边和中央前房变浅，提示 AMS。
最初的药物治疗，包括抗青光眼药物和睫状肌麻痹剂，没有效果。行晶状体切除术联合完整前玻璃体切除术和巩膜周边虹膜切除术有助于缓解水性迷路。
玻璃体切割术后可发生 AMS，可能与完整的前玻璃体有关。晶状体切除术联合睫状突-玻璃体-虹膜切除术是必要的。本报告强调了这种罕见并发症的发生及其有效的治疗方法。
