Swan Syndrome

PURPOSE: Swan syndrome, one of the chronic postoperative complications following cataract surgery produces recurrent hyphema from new vessels of the anterior chamber and thereby increases intraocular pressure (IOP). We report the first Korean case of "Swan syndrome". METHODS: A 66-year-old male complained of loss of vision and red eye two months after unplanned extracapsular cataract extraction in the right eye. At our glaucoma clinic, hyphema of 1 mm in height was noticed through a slit lamp. IOP was 33 mmHg. A new vessel at the inlet of the previous scleral tunnel incision was noticed through gonioscopic examination. We diagnosed this case with Swan syndrome. RESULTS: To remove the hyphema, anterior chamber irrigation was performed. However, the hyphema recurred. Therefore argon laser photocoagulation was performed with permanent non-recurrence of the hyphema and IOP was maintained within the normal range. CONCLUSIONS: Swan syndrome which produces recurrent hyphema with resultant blurred vision is associated with neovascularization originated from episcleral vessels. In this case, argon laser photocoagulation was effective in the eradication of the new vessel.

Use of Viscoelastic Substance in Longstanding Recurrent Hyphema Patient

Rebleeding in traumatic hyphema may cause several complications in the affected eye, and specific treatment of recurrent hyphema is still not estabilished and only conservative medical treatments are used except for surgical evacuation of the clot in case of persistent high intraocular pressure. We treated longstanding recurrent hyphema patient unresponsive to conventional medical treatment, with viscoeleastic substance which was injucted into anterior chamber. A large dose(0.2CC) of viscoelastic substance sufficient to directly compress the anterior structures(Iris, ciliary body) was injected and subsequently it increased the intraocular pressur gradually. We assume that these tamponade effect by the viscoelastic substance and later intraocular pressure rise was responsible for the therapeutic effect. Thus, viscoelastic injection into anterior chamber in longstanding recu.rrent hyphema patient may be a useful treatment.