Uveitis-Glaucoma-Hyphema Syndrome Treated with Haptic Amputation

Introduction

Uveitis-glaucoma-hyphema syndrome, or UGH syndrome, is caused by friction between an artificial intraocular lens (IOL) and the iris or ciliary body [1]. Both anterior and, to a lesser extent, posterior IOLs, especially sulcus implanted lenses, have been associated with UGH syndrome [2]. A possible mechanism to explain this syndrome is the chronic chaffing of the iris or ciliary body that causes a breach in the blood aqueous barrier, eventually leading to an intraocular inflammation and even full-blown uveitis. Hemorrhage is the result of intermittent vessel injury. Glaucoma could result as a reaction to direct injury of the trabecular meshwork in case of anterior chamber IOL or secondary to uveitis, hyphema, and pigment dispersion.

The management of UGH syndrome depends on the severity of the situation. In mild to moderate cases, conservative treatment with a combination of anti-inflammatory and anti-glaucoma medications may be sufficient. In selected cases, laser iridotomy may be beneficial. In more advanced situations, surgical management is necessary, usually with a complete IOL exchange [3], [4], [5].

In this article, we present a case of haptic-induced UGH syndrome, which was successfully managed by an isolated intraoperative IOL haptic amputation.

• References

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• 3 Singh H, Modabber M, Safran SG. et al. Laser iridotomy to treat uveitis-glaucoma-hyphema syndrome secondary to reverse pupillary block in sulcus-placed intraocular lenses: Case series. J Cataract Refract Surg 2015; 41: 2215-2223
• 4 Sousa DC, Leal I, Faria MY. et al. A Rare Manifestation of Uveitis-glaucoma-hyphema Syndrome. J Curr Glaucoma Pract 2016; 10: 76-78 doi:10.5005/jp-journals-10008-1205
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• 7 Campos X, Ahmed IK, Shah M. IOL Exchange and Double Optic Capture for the Management of Uveitis-Glaucoma-Hyphema Syndrome. Eyetube; 2015. Available at: https://eyetube.net/video/edini/ Accessed 20.07.2018