Laser Iridoplasty For A Case Of Recurring Hyphema: A Case Report

This case report details a recurring case of uveitis-glaucoma-hyphema in a 55 year-old-female successfully managed with peripheral laser iridoplasty. 

Department of Ophthalmology, Unidade Local de Saúde de Matosinhos, Portugal

A case report of a recurring case of uveitis-glaucoma-hyphema in a 55 year-old-female successfully managed with peripheral laser iridoplasty. Assessment of the clinical records and multimodal imaging ( anterior segment optical coherence tomography (AS-OCT) and anterior segment photography) was performed.

A 55-year-old female presented with sudden vision loss, accompanied by hyphema, vitreous hemorrhage, iris transillumination defects and subluxated intraocular lens (IOL). Past ocular history included myopic LASIK and cataract surgery with IOL placement in the ciliary sulcus. The patient underwent vitrectomy with IOL scleral fixation, leading to an absence of new episodes of hyphema and vitreous hemorrhage during a 4-year follow-up. However, she experienced a recurrence of hyphema and vitreous hemorrhage, along with pseudophaco and iridodonesis. AS-OCT revealed apposition of the posterior iris surface to the anterior IOL face. Peripheral diode laser iridoplasty was performed to anteriorize the iris and prevent further contact with the IOL.

In summary, we successfully managed recurrent hyphema and vitreous hemorrhage in a patient with a prior IOL positioned in the ciliary sulcus. Despite an initial attempt at scleral fixation of the IOL, symptoms persisted even after a 4-year follow-up. Subsequently, peripheral diode laser iridoplasty was performed to anteriorize the iris, effectively preventing further contact with the IOL and addressing the recurrent complications. A 2-month follow-up demonstrated no signs of new hyphema or vitreous hemorrhage, with successful separation of the iris from the IOL.