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Glaucoma surgery and blurred vision: an unseen complication

Poster Details

First Author: M.Quiroz Quiroga SPAIN

Co Author(s):    A. Matheu   J. Armentia   R. Falah   N. Najjari   C. Pueyo   O. Pujol     

Abstract Details

Purpose:

To report the differential diagnosis of the corneal edema in a patient with pseudoexfoliation glaucoma who had undergone implantation of Ahmed Glaucoma Valve (AGV).

Setting:

Department of Ophthalmology- Glaucoma Unit Hospital de l'Esperan├ža - Parc de Salut Mar Barcelona-Spain

Methods:

The present case report describes the case of a 67-year-old male with pseudoexfoliation glaucoma in both eyes who was referred from the emergency room after he presented with blurred vision and photophobia in the right eye (OR) since 2 weeks. Best corrected visual acuity (BCVA) was 0,15 (previous was 0,8) in the right eye and 0,05 in the left eye (Terminal glaucoma). Slit-lamp examination revealed stromal and epithelial corneal edema, keratics precipitates and faint anterior chamber reaction. The patient was treated as an herpetic stromal keratitis. Three days later, corneal edema persists and BCVA was the same.

Results:

He had undergone implantation an AGV in the OR 3 years ago and a trabeculectomy (TBC) in the left eye (OS) 17 years before. Although the AGV's tube was previously observed normosituated in the anterior chamber (AC), with eyes movements the tube contacted de superior corneal endothelium. The anterior segment optical coherence tomography (AS-OCT) confirm the findings and the diagnosis of corneal decompensation was made. The AGV's tube was promptly removed from the AC and repositioned in ciliary sulcus (CS) by surgery. At 2 month postoperative, the BCVA was 0,25 and the corneal edema has improved but it still persists.

Conclusions:

Corneal descompensation is a long-term complication of AGV. A careful exploration of the tube with eye movements it might be the key to reach the correct diagnosis.

Financial Disclosure:

None

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