Surgical Treatment Of Hypermature Cataract With Fuchs Uveitis And Secondary Glaucoma, Questionable Expectations And Visual Acuity Benefit Of 100%

To show the complex case of hypermature cataract with Fuchs uveitis and heterochromia, posterior synechiae, bleeding in the ventricular angle followed with increased intraocular pressure. We performed PHACO operation technique with 3 piece intraocular lens implantation. Unexpected visual acuity and stabilisation of the Fuchs uveitis symptoms have been obtained.  

Eye Clinic Svjetlost-Sarajevo

 A 65-year-old woman came to our institution for an examination for the first time. She had previous treatment at different healthcare institution. During the examination right eye visual acuity was L+P-, left eye visual acuity 0,80 cc+0,50 Dsph 0,90, intraocular pressure regulated with local antiglaucoma therapy TOD:18 mmHg, TOS:16 mmHg. Biomicroscopally detected heterochromia on the right eye followed with bleeding in the venrticular angle, Fuchs uveitis, Keratic precipitates, Tyndal ++, shallow anterior chamber, posterior synechiae and hypermature cataract. For the left eye incipient cataract has been found. The fundus of the right eye cannot be evaluated due to hypremature cataract, while left eye fundus had escavation of 0,5 and sclerotized blood vessels. One day after PHACO procedure, on the right eye anterior chamber had hyphema for 2,5 mm, Tyndal ++, pseudophakia and increase of intraocular pressure to 30 mmHg and visual acuity of 0,20 s.c. Local corticosteroid and antiglaucoma theraphy with acetazolamide seven days after therapy created stabilisation while hyphema has been resorbed, Tyndal +, intraocular pressure was 10 mmHg and VOD: 1,0 s.c. Right eye fundus PVD, PPA, C/D:0,50, macula with pigment rearrangement and sclerotized blood vessels

Complex opthalmological pathology with severe cataract, Fuchs uveitis, visual acuity L+P- and increased intraocular pressure can be unrecognized, but with adquate surgical treatment can be eliminated. This case shows visual acuity can be increased up to 100%  when right surgical treatment has been applied. This techinique can prevent complications from primary Fuchs uveitis also