Posters

Management of acute and chronic fluid misdirection syndrome: factors that have to be taken into account

Poster Details

First Author: F.Hermoso Fernández SPAIN

Co Author(s):    J. Muñoz de Escalona Rojas   R. Anaya Alaminos   M. Perez de Andrade              

Abstract Details

Purpose:

To identify the underlying causes and signs in acute and chronic misdirection syndrome and measures to be considered both, the intrasurgical and in the immediate postoperative period.

Setting:

The description of cases series and cases report.

Methods:

Revision of our medical histories and also we used the PubMed web to find other prospective or retrospective studies.

Results:

Acude fluid misdirection syndrome:  -Signs: Flattening anterior chamber, difficult insertion of the intraocular lens, posterior capsule flaccidity, anterior-Hyaloid membrane detachment during hydrodissection. -Measures: Administration of ocular viscosurgical devices into the anterior chamber as well as dry aspiration of retrocapsular fluid. Severe cases: Pars plana descompression by puncture and aspiration of retrolenticular fluid, or small-gauge trocar vitrectomy cutter and removing the retrocapsular fluid with high cut rate. Chronic fluid misdirection syndrome : -Signs: High intraocular pressure, hypothalmia or athalamia, recent cataract surgery or recent filtering surgery. -Measures: iridotomy and capsulotomy . If not responding:  peripherial vitrectomy, anterior hyaloidectomy, zonulectomy and iridotomy

Conclusions:

'- To identify intraoperative signs or to be aware of first symptoms in chronic syndrome in order to avoid major complications. - To consider the not modifiable risk factors (hyperopic eyes, pseudoexfoliation, etc) and to avoid the modifiable risk factor (utilitation of ocular viscosurgical devices , high levels of anterior chamber irrigation, etc) to prevent the acute misdirection syndrome. -The importance of a good incisonal closure in patients undergoing cataracts with narrow cameras as a prevention of chronic misdirection syndrome and it this happens creating a unique chamber that restores the fluid mechanics of the aqueous humor will be needed.

Financial Disclosure:

None