SUMMARYUveitis-glaucoma-hyphaema (UGH) syndrome is commonly reported following intraocular lens (IOL) implantation in the anterior chamber or malpositioned posterior chamber IOLs. It is extremely rare to have this complication in an eye with intact posterior capsule and a well placed in-the-bag IOL. We report a case of a 48-year-old man who presented with blurred vision after an uneventful cataract surgery in the right eye, and who was treated for anterior uveitis. The anterior chamber inflammation persisted despite intense treatment with topical steroids for 2 months, and the intraocular pressure was high. The posterior chamber IOL was in the bag and well covered by a capsulorrhexis margin. Dilated gonioscopy revealed inferior capsular bag hyphaema secondary to the superior haptic displacement due to a tear in the equatorial bag. Our case highlights the importance of dilated gonioscopy and a rare possibility of UGH syndrome in an eye with a well-placed IOL.
BACKGROUND
The ocular manifestations of Marfan's syndrome (MS) range from ectopia lentis, microspherophakia, myopia, glaucoma and retinal detachment. Spontaneous scleral rupture is a rare complication and recurrent scleral perforation is extremely rare. We report a rare case of a 26-year-old male with MS who had sequential recurrent spontaneous scleral rupture which required surgical repair. He suffered from a similar problem 4 years later in both eyes in a different location, with overlying thin cystic blebs and hypotony maculopathy. Surgical repair with preserved scleral donor patch graft and conjunctival autograft in one eye, and conjunctival advancement in the other eye was performed. This helped stabilise the eyes, and resulted in complete visual recovery in both eyes.
AGV implantation had good success rate in refractory pediatric glaucoma. The success rates were similar in PCG and SPG as were the complications. Number of prior intraocular surgeries was a risk factor for failure.
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