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Kim, Lee, Kang, and Shin: A Case of Vitreous Prolapse through Iridectomy Site after Trabeculectomy
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(4): 602-606.

Published online: 17 April 2012

DOI: https://doi.org/10.3341/jkos.2012.53.4.602

A Case of Vitreous Prolapse through Iridectomy Site after Trabeculectomy

Min Uk Kim, MD, Hyou Kyung Lee, MD, Shin Hee Kang, MD, Min Chul Shin, MD, PhD

Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

Address reprint requests to Shin Hee Kang, MD. Department of Ophthalmology, Chuncheon Sacred Heart Hospital, #77 Sakju-ro, Chuncheon 200-704, Korea. Tel: 82-33-240-5000, Fax: 82-33-255-6244, slug7475@yahoo.co.kr

Received 24 January 2011       Accepted 16 March 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy.

Case summary

Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized.

Conclusions

In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.

Keywords: Anterior vitrectomy, Trabeculectomy, Vitreous prolapse

Figures and Tables

Figure 1
(A) POD#97, the intraocular pressure elevated and the height of bleb became flat. The anterior chamber was well maintained and the iridectomy site looked patent on slit lamp examination. (B) On gonioscopic examination, it was found that the inner ostium was obstructed by prolapsed vitreous strands through the iridectomy site (arrow).
jkos-53-602-g001
Figure 2
(A) After anterior vitrectomy, the bleb recovered filtering function taking on a diffuse and prominent looking appearance. (B) Since the anterior vitrectomy, there have been no recurrences of vitreous prolapse into the anterior chamber for 11 months.
jkos-53-602-g002

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