Urrets-Zavalia Syndrome Following Trabeculectomy

Gi Seok Park; Yeo Kyoung Won; Kyoung Nam Kim; Yeon Hee Lee; Chang-sik Kim

doi:10.3341/jkos.2020.61.2.221

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Park, Won, Kim, Lee, and Kim: Urrets-Zavalia Syndrome Following Trabeculectomy

Case Report

Journal of the Korean Ophthalmological Society 2020; 61(2): 221-225.

Published online: 18 February 2020

DOI: https://doi.org/10.3341/jkos.2020.61.2.221

Urrets-Zavalia Syndrome Following Trabeculectomy

Gi Seok Park, MD, Yeo Kyoung Won, MD, Kyoung Nam Kim, MD, PhD, Yeon Hee Lee, MD, PhD, Chang-sik Kim, MD, PhD

Department of Ophthalmology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.

Address reprint requests to Kyoung Nam Kim, MD, PhD. Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: 82-42-280-7604, Fax: 82-42-255-3745, kknace@cnuh.co.kr

Received 26 July 2019 Revised 6 September 2019 Accepted 20 January 2020

The Korean Ophthalmological Society

(open-access):

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

We report a case of Urrets-Zavalia syndrome with a fixed dilated pupil after an uneventful trabeculectomy.

Case summary

Trabeculectomy was performed on a 51-year-old male who had a history of recurrent uveitis in the left eye, with uncontrolled intraocular pressure despite maximally-tolerated medial therapy. There was no unexpected event during surgery. Topical 1% atropine was used for only 2 days after surgery. In the early postoperative period, 1% prednisolone and 0.3% ofloxacin were given four times a day, then gradually reduced. One month later, only 1% prednisolone was given once a day. Intraocular pressure in his left eye was well controlled from 8–14 mmHg after surgery. One month after surgery, the pupils remained dilated. There was no reaction to topical 2% pilocarpine and no relative afferent pupillary defect or posterior synechia.

Conclusions

Our case, although rare, suggests that Urrets-Zavalia syndrome should be considered in patients with well-controlled intraocular pressure after uneventful trabeculectomy.

Keywords: Dilation, Pathologic, Pupil, Trabeculectomy, Urrets-Zavalia syndrome

Figures and Tables

Figure 1

Anterior segment photographs captured just prior to (A) and immediately after (B) trabeculectomy. (A) Pilocarpine 2% was applied preoperatively and successful miosis was observed. (B) A filtering bleb and iridectomy site were shown in the superior nasal quadrant. There was no pupil injury during surgery, and there was no increase in the diameter of the pupil compared to before surgery.

Figure 2

Anterior segment photographs, 12 months after trabeculectomy. There was no change in pupil diameter in response to lighting. (A) Under the diffuse illumination of the slit lamp. (B) Under indirect illumination (dim light) of the slit lamp. Round-shaped iris atrophy (arrows) was detected.

Figure 3

Anterior segment photographs, 7 months after trabeculectomy (A, B). (B) The pupil became slightly dilated after instillation of 0.5% tropicamide and 0.5% phenylephrine mixed eye drops. There was no posterior synechia.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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