A Case of Hyphema after Selective Laser Trabeculoplasty

Sungsoon Hwang; Jong Chul Han; Chang Won Kee

doi:10.3341/jkos.2016.57.9.1489

Journal List > J Korean Ophthalmol Soc > v.57(9) > 1010409

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Hwang, Han, and Kee: A Case of Hyphema after Selective Laser Trabeculoplasty

Case Report

J Korean Ophthalmol Soc 2016;57(9):1489-1492.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.9.1489

A Case of Hyphema after Selective Laser Trabeculoplasty

Sungsoon Hwang, MD, Jong Chul Han, MD, Chang Won Kee, MD, PhD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Chang Won Kee, MD, PhD Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: 82-2-3410-3548, Fax: 82-2-3410-0074 E-mail: ckee@skku.edu

Received 19 May 2016 Revised 4 July 2016 Accepted 8 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of hyphema after selective laser trabeculoplasty (SLT) in a patient with pseudoexfoliative glaucoma.

Case summary

A 77-year-old female was referred for elevation of intraocular pressure (IOP). Previously, she had been diagnosed with pseudoexfoliative glaucoma in the right eye and was using topical IOP-lowering agents. The best corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. IOP, measured with Goldmann applanation tonometer, was 32 mm Hg in the right eye and 20 mm Hg in the left eye. Gonioscopy revealed open-angle glaucoma with +2 trabecular meshwork pigmentation but without peripheral anterior synechiae or neovascularization. SLT was performed in the right eye. Two days later, the patient had sudden onset of blurred vision and pain in the right eye. Visual acuity was limited to light perception, and IOP was 34 mm Hg in the right eye. Slit-lamp examination revealed 1.1 mm hyphema with 4+ red blood cell count in the anterior chamber. Three weeks after the SLT, hyphema in the right eye disappeared, but IOP was measured to be 42 mm Hg. The patient underwent trabeculectomy in the right eye.

Conclusions

SLT is an effective means of lowering IOP with low risk of complications. However, hyphema can rarely occur after SLT and can affect the outcome of the treatment.

Keywords: Hyphema, Open-angle glaucoma, Selective laser trabeculoplasty

References

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Figure 1.

Anterior segment photographs, 2 days after selective laser trabeculoplasty. (A) Slit-lamp examination demonstrates hyphema of 1.1 mm in height. (B) 4+ red blood cell count is noted in the anterior chamber.

Figure 2.

Anterior segment phorographs, 1 month after trabeculectomy. (A) Hyphema in the right eye has disappeared. (B) Gonioscopy revealed open-angle without any peripheral anterior synechiae or neovascularization.

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