Scleral Fixation Of An Intraocular Lens Using The Canabrava Technique In Uveitis–Glaucoma–Hyphema Syndrome: A Case Report

To report a case of uveitis–glaucoma–hyphema (UGH) syndrome associated with vitreous hemorrhage secondary to intraocular lens (IOL) malposition, managed surgically with scleral fixation using the Canabrava technique.

Pedro Lagleyze Public Ophthalmologic Hospital, Buenos Aires, Argentina.

A 67-year-old woman with high myopia, previous laser-assisted in situ keratomileusis, and prior cataract surgery presented with blurred vision in the left eye. Comprehensive ophthalmologic evaluation included best-corrected visual acuity (BCVA), slit-lamp examination, Goldmann applanation tonometry, dilated fundus examination, ultrasound biomicroscopy (UBM), B-scan ultrasonography, and optical biometry. Initial management consisted of maximal topical anti-inflammatory and intraocular pressure–lowering therapy. Due to persistent inflammation and inadequate IOP control, IOL explantation and secondary scleral fixation using the Canabrava technique were performed.

BCVA was 20/20 in the right eye and hand motion in the left eye. Intraocular pressure was 20 mmHg and 26 mmHg, respectively. Slit-lamp examination of the left eye revealed conjunctival hyperemia, sectoral iris atrophy with transillumination defects, anterior chamber inflammation, pigment dispersion, dyscoria, a hyporeactive pupil, and posterior synechiae. UBM confirmed a malpositioned posterior chamber IOL with haptic–iris contact. Postoperatively, inflammation resolved, visual acuity improved by one Snellen line, and intraocular pressure was adequately controlled.

Secondary scleral fixation using the Canabrava technique may represent a safe and effective surgical option in UGH syndrome refractory to medical therapy. UBM plays a key role in confirming the diagnosis and guiding surgical planning.