ABSTRACT
This is a single case report of an elderly patient who had blunt trauma in an eye that had phacoemulsification and two trabeculectomies. She had good vision with a well-functioning bleb before the trauma. She presented during her routine follow-up visit for glaucoma with isolated aniridia and an intact globe. The capsular bag, zonules, and the intraocular lens were intact. The cupping was 0.8, and the rest of the fundus and macula were normal. Pigments were seen over the sclera extending posteriorly upto the fornix. Gonioscopy revealed only faint pigments at the fistula. Following the trauma, the intraocular pressure had increased to 26 mm Hg. The mechanism and the management of the glaucoma are discussed.
Subject(s)
Aniridia/etiology , Eye Injuries/complications , Glaucoma, Open-Angle/complications , Postoperative Complications , Pseudophakia/complications , Trabeculectomy/adverse effects , Aged , Aniridia/diagnosis , Eye Injuries/diagnosis , Female , Glaucoma, Open-Angle/surgery , Humans , PhacoemulsificationABSTRACT
Two cases of complicated hyphaema associated with sickle cell trait are presented. The pathophysiology, diagnosis and management of raised intraocular pressure in sickle cell trait are discussed.
Subject(s)
Eye Injuries/complications , Hyphema/etiology , Sickle Cell Trait/complications , Wounds, Nonpenetrating/complications , Adult , Child , Hemoglobin, Sickle/analysis , Humans , Intraocular Pressure , Male , Ocular Hypertension/etiology , Sickle Cell Trait/diagnosisABSTRACT
BACKGROUND: Glaucoma drainage devices are more commonly inserted into the anterior chamber because of the relative ease of this method of insertion. However, in certain cases, posterior placement of the tube may be necessary or may be more desirable. The outcome of a series of patients with glaucoma drainage devices inserted into the pars plana was examined. METHODS: Retrospective chart review of patients who underwent pars plana implantation of Molteno and Baerveldt glaucoma drainage devices at the Sydney Eye Hospital. RESULTS: There were 33 cases reviewed. The mean follow-up period was 30.2 months. The mean final postoperative intraocular pressure was reduced to 13.4 +/- 4.4 mmHg (SD) from 33.06 +/- 8.47 mmHg preoperatively. The mean number of intraocular pressure-lowering medications in use postoperatively was 0.6 +/- 0.8, reduced from 3.6 +/- 1.27 medications in use preoperatively. Sixteen (48.5%) eyes were classified as complete successes, 14 (42.4%) eyes as qualified successes and three eyes (9%) as failures. Kaplan-Meier survival analysis for cumulative success (absence of failure) predicted 61.1% survival at 60 months. Complications included five cases of decompensation of corneas or corneal grafts, one case each of conjunctival wound dehiscence, large choroidal effusion, epiretinal membrane, Molteno plate extrusion and intraocular pressure unresponsive to medical therapy, and three cases of tube blockage. CONCLUSIONS: In this series of patients, pars plana insertion of glaucoma drainage devices has been shown to be an effective alternative for selected cases where anterior chamber tube insertion is not possible or is not ideal.