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Case from hell in narrow angle glaucoma patient
Author(s) -
VAN DE VEIRE S,
WEBERS C,
BECKERS H
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.2458.x
Subject(s) - medicine , intraocular pressure , uveitis , glaucoma , ophthalmology , acetazolamide , implant , glaucoma surgery , surgery , anesthesia
Purpose To present the complicated case of a young man with Bechterew uveitis and secondary glaucoma, who underwent glaucoma implant surgery. Methods From the age of 8 years he presented with multiple attacks of anterior uveitis of his right eye. Each attack was treated with high dose of corticosteroids, leading to pressure rise. Quickly tampering the amount of steroids lead to reactivation of his uveitis. From 2011 on, he developed intraocular pressures up to 40 mmHg, treated with local drops and acetazolamide. Results A tube implantation (Baerveldt 350) was performed with good eye pressure for the first 6 postoperative weeks continuing under maximal therapy (due to the Vicryl ligature). After these 6 weeks he developed multiple attacks of hypotony, for what an anterior chamber filling was performed each time with different types of viscoelasticum. After 3 attempts a bleb revision was performed, leading again to a massive intraocular pressure rise. Mainwhile the uveitis remained fairly inactive. Conclusion Patients with juvenile rheumatoid arthritis often have a very difficult intraocular pressure regulation. Their response to a Baerveldt implantation is really unpredictable. It is either too high or too low.