Aim: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089895PMC
http://dx.doi.org/10.18240/ijo.2023.04.21DOI Listing

Publication Analysis

Top Keywords

aqueous misdirection
16
choroidal effusions
12
misdirection complicated
12
persistent choroidal
8
effusions implantation
8
implantation preserflo
8
preserflo microshunt
8
case aqueous
8
complicated subsequent
8
combined aqueous
4

Similar Publications

Treatment of pseudophakic aqueous misdirection syndrome.

Sci Rep

January 2025

Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.

To describe the management and clinical course of 12 cases of pseudophakic aqueous misdirection syndrome (AMS). Twelve eyes of 12 Patients diagnosed with pseudophakic AMS between 2021 and 2022 were included. Best-corrected visual acuity, refraction, intraocular pressure (IOP), anti-glaucomatous medication, spectral domain ocular coherence tomography (SD-OCT) and postoperative complications were evaluated.

View Article and Find Full Text PDF
Article Synopsis
  • The study examines the causes of acute fluid misdirection (AFM) during cataract surgery and assesses the effectiveness of irido-zonulo-hyaloido-vitrectomy (IZHV) as a treatment for this condition.
  • Six cases of AFM out of over 95,000 cataract surgeries were reported, with most patients having angle closure disease or open-angle glaucoma.
  • IZHV successfully resolved the AFM, leading to improved intraocular pressure and deeper anterior chambers in all patients during follow-up, demonstrating its potential as a viable surgical option for managing AFM.
View Article and Find Full Text PDF

A capsular tension ring (CTR) is used for support to stabilize the capsular bag and intraocular lens (IOL) during and after cataract surgery. Although complications involving the CTR-IOL complex are not uncommon, cases of anterior displacement leading to complications are rare. This report presents a case of secondary angle closure caused by anterior displacement of the CTR-IOL complex due to aqueous misdirection and reports unique findings noted on anterior segment optical coherence tomography (AS-OCT).

View Article and Find Full Text PDF

Purpose: To report a challenging Descemet Membrane Endothelial Keratoplasty (DMEK) case, complicated by intraoperative aqueous misdirection and spontaneous anterior chamber fibrin reaction.

Methods: A 70-year-old female affected by corneal edema due to Fuchs endothelial dystrophy underwent a triple procedure (cataract extraction - IOL implantation - DMEK surgery) in her left eye. This report illustrates the management of the intraoperative complications of aqueous misdirection syndrome and anterior chamber fibrin reaction.

View Article and Find Full Text PDF

Aqueous misdirection syndrome: clinical outcomes and risk factors for treatment failure.

Graefes Arch Clin Exp Ophthalmol

July 2024

VST Center for Glaucoma, L V Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, 500034, Telangana, India.

Purpose: To evaluate the outcomes of postoperative aqueous misdirection and factors predicting failure of interventions.

Methods: This retrospective study included 49 eyes from 47 patients with aqueous misdirection following glaucoma or cataract surgery. Resolution of aqueous misdirection (AM) was deepening of the central anterior chamber (AC) and intraocular pressure (IOP) ≤ 21 mmHg.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!