Dossantos Jason, Bade Yusuf, Halawa Omar, Sabharwal Jasdeep, An Jella
Department of Ophthalmology, George Washington University School of Medicine and Health Sciences, District of Columbia, Washington, DC, USA.
Wilmer Eye institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Case Rep Ophthalmol. 2024 Apr 20;15(1):383-387. doi: 10.1159/000538063. eCollection 2024 Jan-Dec.
Uveitis-glaucoma-hyphema (UGH) syndrome is an infrequent but severe complication following intraocular lens implantation, characterized by anterior chamber inflammation and elevated intraocular pressure (IOP). This report presents a rare case of late-onset UGH syndrome induced by a well-positioned 1-piece posterior capsular intraocular lens (PCIOL) with a bulb of the haptics extruding through a peripheral capsular tear in a 90-year-old female, 17 years post-cataract surgery.
The patient presented with persistent blurred vision, recurrent anterior uveitis, and uncontrolled IOP despite medical therapy. Extensive evaluation, including ultrasound biomicroscopy, failed to identify the underlying cause, necessitating surgical intervention to control IOP. During concurrent goniotomy and canaloplasty, a PCIOL haptics was discovered protruding through a peripheral capsular tear, establishing the diagnosis. Following PCIOL-haptic amputation and goniotomy and canaloplasty, the patient experienced significant improvement in symptoms and IOP control, with complete resolution of UGH syndrome.
This case highlights the necessity of considering atypical causes in persistent postoperative uveitis and IOP elevation and emphasizes the role of surgical intervention in managing complex cases.
葡萄膜炎-青光眼-前房积血（UGH）综合征是人工晶状体植入术后一种罕见但严重的并发症，其特征为前房炎症和眼压（IOP）升高。本报告介绍了一例罕见的迟发性UGH综合征病例，该病例发生在一名90岁女性患者身上，白内障手术后17年，一枚位置良好的一体式后房型人工晶状体（PCIOL）的襻球部通过周边囊膜撕裂处挤出，引发了UGH综合征。
患者出现持续视力模糊、复发性前葡萄膜炎，尽管接受了药物治疗，但眼压仍无法控制。包括超声生物显微镜检查在内的广泛评估未能确定潜在病因，因此需要进行手术干预以控制眼压。在同时进行前房角切开术和小梁切开术时，发现一枚PCIOL襻通过周边囊膜撕裂处突出，从而确诊。在进行PCIOL襻切断术以及前房角切开术和小梁切开术后，患者的症状和眼压控制情况有了显著改善，UGH综合征完全缓解。
本病例强调了在持续性术后葡萄膜炎和眼压升高时考虑非典型病因的必要性，并强调了手术干预在处理复杂病例中的作用。
