Posters

Surgical techniques for the treatment of aqueous misdirection in pseudophakic eyes after cataract surgery

Poster Details

First Author: P. Moinul CANADA

Co Author(s):    M. Luong   J. Bhamra   A. Kherani   J. McWhae   A. Crichton        

Abstract Details

Purpose:

To describe surgical techniques in eyes refractory to medical therapy for successful management of aqueous misdirection following cataract surgery.

Setting:

Rockyview General Hospital and Calgary community clinics, Calgary, Alberta, Canada

Methods:

This retrospective case series analyzed the medical charts of four patients (7 eyes). All patients (age range, 37 – 79 years) presented with shallow anterior chambers, narrow angles, intraocular pressures (IOPs) controlled with medical therapy and a myopic shift in vision following cataract surgery. A stepwise approach to management beginning with pressure-lowering eye drops followed by laser therapy and finally surgical iridozonulohyaloidectomy (IZH) with vitrectomy was performed until symptoms resolved. Best-corrected visual acuities, refractive corrections, IOPs and the average number of glaucoma medications before and after each therapy were determined for each patient.

Results:

Aqueous misdirection, refractory to medical management, showed clinical improvements in uncorrected vision, intraocular pressures, and anterior chamber depth with surgery or laser iridozonulohyaloidectomy. Six eyes were made unicameral with surgical IZH and posterior vitrectomy whereas this state was achieved in one eye with laser therapy alone. Three patients (6 eyes) were also tapered off all glaucoma medications after the eyes were made unicameral.

Conclusions:

Given the clinical findings of aqueous misdirection after uncomplicated cataract surgery, there is a spectrum of interventions that can be embarked upon. This study highlights the benefits of laser and surgical management (to make the eye unicameral) to improve vision and IOP.

Financial Disclosure:

NONE