The uveitis–glaucoma–hyphema syndrome. Part 2. Comparative analysis of existing treatment methods effectiveness

Abstract

Background: The uveitis–glaucoma–hyphema syndrome is a disease caused by iris injury due to extracapsular fixation of intraocular lens (IOL). ES Treatment involves IOL fixation or exchange. Aim: To compare the effectiveness of various surgical methods of uveitis–glaucoma–hyphema syndrome treatment. Materials and methods: The study group included 95 patients (95 eyes), divided into six subgroups depending on surgical treatment methods used: hydrophobic IOL exchange on hydrophilic model (HYDRO) with its transscleral fixation (n = 20); transscleral fixation (TSF) of native IOL (n = 18); hydrophobic IOL exchange on polymethylmethacrylate iris-claw IOL (CLAW; n = 22); iris-fixated IOLs (IRIS; n = 8); IOL immobilization with scleral bandage sutures (BS; n = 4); conservative treatment (CT; n = 23). The methods were compared using a scoring system. Results: The final score of surgical methods effectiveness is presented in descending order: HYDRO — 5.36 ± 1.05, TSF — 5.21 ± 1.80, CLAW — 3.87 ± 3.34, IRIS — 1.26 ± 4.41, BS — –0.74 ± 3.66, CL — –3.26 ± 2.51 (p 0.001). CONCLUSIONS: Uveitis–glaucoma–hyphema syndrome surgical management is a complex problem due to necessity of several interventions performing directed to eliminate the cause factor of recurrent hemorrhages — mechanical traumatization of iris by IOL. The comparison of various surgical techniques demonstrated the greatest effectiveness of HYDRO, TSF, and CLAW. Suture fixation of the IOL to the iris showed slightly less effectiveness. Using of bandage sutures for UGH treatment is inappropriate due to the high risk of relapse.