Recurrent, Delayed-Onset Hyphema Following iStent Inject Managed With Device Removal: A Case Report.
Farazdaghi Marybeth K, Lyons Lance J, Roddy Gavin W
AI Summary
This case reports recurrent, delayed hyphema after iStent Inject, successfully managed by device removal. It suggests hyphema resulted from blood reflux into the anterior chamber via collector channels when IOP dropped, highlighting a potential complication and its treatment.
Abstract
Minimally invasive glaucoma surgeries have become increasingly popular in recent years, with the iStent Inject trabecular micro-bypass device (Glaukos, Laguna Hills, CA) being a well-tolerated treatment option for mild to moderate glaucoma, available for placement at the time of cataract surgery. While there have been reports of hyphema in the immediate postoperative period, there is little information available regarding etiology and management of delayed-onset, recurrent hyphema following iStent Inject placement. We present a case of recurrent hyphema occurring after iStent Inject placement and describe successful management with surgical removal of the device. Since we observed a reflux of heme originating from the site of stent placement into the anterior chamber intraoperatively when the intraocular pressure was lowered, we hypothesize that placement of the device into a collector channel allowed for influx of heme when the intraocular pressure dropped below episcleral venous pressure.
MeSH Terms
Shields Classification
Key Concepts4
A case of recurrent hyphema occurring after iStent Inject placement was successfully managed with surgical removal of the device.
It is hypothesized that the placement of the iStent Inject device into a collector channel allowed for influx of heme into the anterior chamber when the intraocular pressure dropped below episcleral venous pressure, leading to recurrent hyphema.
Minimally invasive glaucoma surgeries, including the iStent Inject trabecular micro-bypass device, have become increasingly popular and are a well-tolerated treatment option for mild to moderate glaucoma.
There is little information available regarding the etiology and management of delayed-onset, recurrent hyphema following iStent Inject placement.
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