Topic outline

  • Grand Rounds

    A 54-year-old male presented to the clinic flat anterior chamber 6 weeks after a glaucoma implant device. His vision was 20/200 in the affected eye with an IOP of 10. He had lenticular-corneal touch. His other eye was NLP from presumed POAG. He was taken to the OR for AC reformation with healon on the same day. On post-op day 2, he was noted to have a flat anterior chamber again. A B-scan ultrasound demonstrated shallow choroidal detachments. The patient was brought back to the OR for a second time for a ligation of the GDI tube and reformation fo the AC. On POD2 after the 2nd trip to the OR, the patient was found again to have a flat AC. The patient returned again for a 3rd time to the OR for drainage of his choroidal effusions. On POD1, his AC remained deep, however on POD3 of his 3rd trip to the OR, his AC flattened again. Finally, he returned to the OR for a 4th time for a cataract extraction with IOL implantation, pars plana vitrectomy, AC retaining suture, two peripheral iridotomies for suspicion of aqueous misdirection. The final diagnosis was aqueous misdirection after glaucoma drainage implant. 4 weeks after the 4th trip to the OR, the patient's chamber remained deep, and his vision returned back to a baseline of 20/40, with an IOP of 12.

    Presentation Date: 09/05/2019
    Issue Date: 08/01/2020