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A. Abazari, N. G. Ghazi; A New Ultrasound-Guided Surgical Technique for the Management of Idiopathic Uveal Effusion Syndrome in Eyes With Normal Axial Length. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3615.
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To describe a modified surgical technique with ultrasound guidance for the management of idiopathic uveal effusion syndrome (IUES) in eyes with normal axial length.
A consecutive case series of four eyes of three patients with IUES with normal axial length was reviewed. The diagnosis was based on a detailed ophthalmic exam, fluorescein angiography, B-scan ultrasonography, biometry, and MRI. All eyes underwent a hybrid procedure consisting of an anterior circumferential sclerostomy combined with an equatorial sclerectomy and sclerostomy without scleral flaps or vortex vein decompression. The sclerostomy site was based subjacent to the area of maximal chorodial swelling as guided by ultrasound. The sclerectomy tissue was submitted for histology.
All patients were males with a mean age of 47 years and a mean follow up of 10 months following surgery. All four eyes had anterior choroidal swelling that was associated with chronic (duration of 1-3 months) total retinal detachment in two eyes and acute appositional angles in the other two. One patient developed uveal effusion in the fellow eye during follow up. Following the ultrasound-guided, hybrid surgical technique described above, all eyes had resolution of the choroidal and subretinal fluid with deepening of the angle within 1-2 months after surgery. The two eyes with long standing retinal detachment had only slight improvement of visual acuity despite the resolution of retinal and choroidal detachment after surgery. Light microscopy of the sclerectomy specimens was unremarkable with no evidence of mucopolysaccharide deposition.
This new ultrasound-guided, hybrid surgical technique of anterior circumferential sclerostomy combined with equatorial sclerectomy and sclerostomy appears to be effective in the management of idiopathic uveal effusion syndrome despite a normal axial length. The final visual acuity, however, may be limited by a long-standing serous retinal detachment
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