Combined aqueous misdirection and persistent choroidal effusions following implantation of a Preserflo MicroShunt
作者机构：University Hospitals of Leicester Leicester Royal Infirmary Infirmary Square Leicester LE1 5WW *** United Kingdom Queens Medical Centre Derby Road Nottingham NG7 2UH United Kingdom
出 版 物：《International Journal of Ophthalmology》
年 卷 期：2023年第16卷第4期
主 题：combined aqueous misdirections persistent choroidal effusions
摘 要：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.