September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Uveitis, Glaucoma, Hyphema Syndrome: A Referral-Based, Retrospective Analysis
Author Affiliations & Notes
  • Trevor A Smith
    Ophthalmology, Beaumont Health - Royal Oak, Royal Oak, Michigan, United States
  • Albert Cheung
    Ophthalmology, Beaumont Health - Royal Oak, Royal Oak, Michigan, United States
  • John C. Hart
    Ophthalmology, Beaumont Health - Royal Oak, Royal Oak, Michigan, United States
  • Charity Chen
    Ophthalmology, Beaumont Health - Royal Oak, Royal Oak, Michigan, United States
  • Footnotes
    Commercial Relationships   Trevor Smith, None; Albert Cheung, None; John Hart, None; Charity Chen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2951. doi:
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      Trevor A Smith, Albert Cheung, John C. Hart, Charity Chen; Uveitis, Glaucoma, Hyphema Syndrome: A Referral-Based, Retrospective Analysis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2951.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Uveitis–glaucoma–hyphema syndrome (UGH) is caused by improper intraocular lens (IOL) positioning, which results in mechanical trauma to uveal tissue. The purpose of this study was to examine the effect that IOL implant type and position have in patients who develop UGH. We performed a ten-year retrospective chart review to determine if different IOL types and positions were associated with varying degrees of UGH severity as well as varying amounts of visual impairment.

Methods : We reviewed 249 patients who were referred to an anterior segment surgeon for IOL reposition or exchange. Of these patients 56 eyes of 53 patients were documented to have UGH at presentation. All eyes had IOL repositioning or exchange by a single surgeon (JCH). The involved eyes were sorted based on the type and position of the IOL. One-piece posterior chamber (PC) IOLs, three-piece PC IOLs, and anterior chamber (AC) IOLs were compared. Initial and final visual acuities; time from cataract surgery to diagnosis of UGH; number of ophthalmologists seen prior to diagnosis of UGH; and development of glaucoma, uveitis/CME, and hyphema/vitreous hemorrhage were outcome measures.

Results : Patients who developed UGH caused by an AC IOL had worse initial and final visual acuities and were more likely to develop glaucoma or CME than any other group. This group also had the longest time from cataract surgery to diagnosis of UGH (mean 6.7 years) and saw the greatest number of ophthalmologist prior to diagnosis of UGH. One-piece PC IOLs were diagnosed with UGH earlier than any other group (mean 4.4 years). Patients with either one- or three-piece PC IOLs who developed UGH had similar initial and final visual acuities as well as similar rates of development of glaucoma and uveitis/CME. There was a considerable delay for all groups from the time of cataract surgery until the diagnosis of UGH despite being evaluated by multiple ophthalmologists. Eyes were often treated for uveitis, glaucoma, or hyphema/VH without recognition of underlying UGH.

Conclusions : Patients who had UGH caused by AC IOLs fared worse than any other group. PC IOLs tended to act equivalently in terms of time to diagnosis, development of glaucoma and uveitis/CME, and final visual outcomes. Ophthalmologists should recognize the signs of UGH earlier in order to decrease morbidity from this sight threatening complication of cataract surgery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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