COMPLICATIONS OF SERIAL ANTERIOR CHAMBER PARACENTESIS FOR INCREASED INTRAOCULAR PRESSURE AFTER INTRAVITREAL INJECTIONS.

Purpose: To report complications after serial anterior chamber (AC) paracentesis for sustained elevation of intraocular pressure after intravitreal injection.

Methods: A retrospective interventional case series of five patients who had received AC paracentesis after intravitreal injection.

Results: Five patients presented with either decreased vision or increased pain after intravitreal injection with planned AC paracentesis. Of the five patients, three patients presented with profound hypotony due to persistent wound leak from the AC paracentesis site. Of these three, one resolved with pressure patch and cycloplegia. The other two patients required further intervention with either polyethylene glycol hydrogel or nylon suture for wound closure. The fourth patient presented with IOL optic prolapse into the AC that resolved with dilation. The fifth patient presented with vitreous prolapse through the AC paracentesis wound and was treated with YAG vitreolysis.

Conclusion: A single AC paracentesis has been shown to demonstrate a favorable safety profile. Serial AC paracenteses may degrade the integrity of the peripheral cornea in patients with sustained elevation of intraocular pressure after repeated intravitreal injections.