This is a video shared by Dr. Renato Rosário and Dr. André Maia from São Paulo Brazil.
This is a case of a 50 years old Male with recurrent vitreous hemorrhage and glaucoma in OD. As ocular conditions, patient had High Myopia, Dome-Shaped maculopathy and a previous history of RRD in the left eye. His BCVA was 20/40 in the right eye, the IOP was 19mmHg and in the slit-lamp examination patient had a 3-pieces IOL in the ciliary sulcus.
After further investigation the angiogram showed no areas of retinal ischemia and an UBM showed a haptic touching the ciliary body.
The diagnosis was Uveitis-Glaucoma-Hyphema syndrome and pars plana vitrectomy and IOL removal was indicated.
Surgeon performed first a scleral sulcus and then 23-gauge trocars were inserted. It is interesting to see the endoscopy images that shows the contact between the IOL haptic and the ciliary body. It was probably the cause of recurrent vitreous hemorrhage in this case.
The IOL and the capsular complex were totally removed. Once patient had a IOL with zero power in the Biometry calculations, a new IOL implant was not programmed in this case. After removal, surgeon used the endoscopy to review vitreous base and the ciliary body. Using the endoscopy it is also possible to see the trabecular meshwork.
To control better the intraocular pressure, an I-stent was implanted. In the end of the surgery, to avoid suteres, the tissue glue was used to close the conjunctiva.
Vídeo: Renato Rosario MD
André Maia MD
Edition: Filipe Lucatto MD
Juliana Prazeres MD