Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC)
Abstract Background To present an unusual intra-operative complication of micropulse transscleral cyclophotocoagulation (MPTSC). Case presentation A 72-year old Chinese gentleman, who had primary angle closure glaucoma and had received bilateral laser iridotomy, presented with progressive left eye b...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12886-020-01669-6 |
| _version_ | 1818216247888707584 |
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| author | Poemen P. Chan Matthew C.W. Lam Nafees Baig |
| author_facet | Poemen P. Chan Matthew C.W. Lam Nafees Baig |
| author_sort | Poemen P. Chan |
| collection | DOAJ |
| description | Abstract Background To present an unusual intra-operative complication of micropulse transscleral cyclophotocoagulation (MPTSC). Case presentation A 72-year old Chinese gentleman, who had primary angle closure glaucoma and had received bilateral laser iridotomy, presented with progressive left eye blurred vision (visual acuity of 20/40 OD and 20/200 OS). Examination reviewed left eye central retinal venous occlusion. The intraocular pressure (IOP) was 19 mmHg OS and was on maximally tolerated topical medications. Four weeks later, the left eye was complication by neovascular glaucoma; the IOP was raised to 26 mmHg despite additional oral acetazolamide and remained elevated after pan-retinal photocoagulation as well as cataract extraction by phacoemulsification. MPTSC was performed 8 days after the phacoemulsification. During the procedure, a sudden protrusion was formed on the corneal surface. On-table examination with operating microscope and portable slit-lamp reviewed an intact corneal epithelium with a globular-shaped collection of fluid at the subepithelial layer – acute corneal subepithelial hydrops (ACSH). The anterior chamber was formed and the globe was intact. After approximately 10–15 minutes, the swelling spontaneously ruptured and became a corneal epithelial defect. The defect healed on the tenth day after the event with conservative management. There was no irreversible corneal damage and the patient subsequently underwent a successful second MPTSC of the left eye because of poorly controlled IOP. Conclusion ACSH is a possible intra-operative complication of MPTSC. We have proposed the possible mechanisms of ACSH. It is best to exercise caution when using MPTSC shortly after any incisional intraocular surgery. |
| first_indexed | 2024-12-12T06:48:57Z |
| format | Article |
| id | doaj.art-8236827237b84c4d826ab9cff591be41 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-12T06:48:57Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-8236827237b84c4d826ab9cff591be412022-12-22T00:34:07ZengBMCBMC Ophthalmology1471-24152020-10-012011610.1186/s12886-020-01669-6Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC)Poemen P. Chan0Matthew C.W. Lam1Nafees Baig2Department of Ophthalmology & Visual Sciences, The Chinese University of Hong KongDepartment of Ophthalmology & Visual Sciences, The Chinese University of Hong KongDepartment of Ophthalmology & Visual Sciences, The Chinese University of Hong KongAbstract Background To present an unusual intra-operative complication of micropulse transscleral cyclophotocoagulation (MPTSC). Case presentation A 72-year old Chinese gentleman, who had primary angle closure glaucoma and had received bilateral laser iridotomy, presented with progressive left eye blurred vision (visual acuity of 20/40 OD and 20/200 OS). Examination reviewed left eye central retinal venous occlusion. The intraocular pressure (IOP) was 19 mmHg OS and was on maximally tolerated topical medications. Four weeks later, the left eye was complication by neovascular glaucoma; the IOP was raised to 26 mmHg despite additional oral acetazolamide and remained elevated after pan-retinal photocoagulation as well as cataract extraction by phacoemulsification. MPTSC was performed 8 days after the phacoemulsification. During the procedure, a sudden protrusion was formed on the corneal surface. On-table examination with operating microscope and portable slit-lamp reviewed an intact corneal epithelium with a globular-shaped collection of fluid at the subepithelial layer – acute corneal subepithelial hydrops (ACSH). The anterior chamber was formed and the globe was intact. After approximately 10–15 minutes, the swelling spontaneously ruptured and became a corneal epithelial defect. The defect healed on the tenth day after the event with conservative management. There was no irreversible corneal damage and the patient subsequently underwent a successful second MPTSC of the left eye because of poorly controlled IOP. Conclusion ACSH is a possible intra-operative complication of MPTSC. We have proposed the possible mechanisms of ACSH. It is best to exercise caution when using MPTSC shortly after any incisional intraocular surgery.http://link.springer.com/article/10.1186/s12886-020-01669-6ACSH case reportAcute corneal subepithelial hydropsMPTSC micropulse transscleral cyclophotocoagulation |
| spellingShingle | Poemen P. Chan Matthew C.W. Lam Nafees Baig Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) BMC Ophthalmology ACSH case report Acute corneal subepithelial hydrops MPTSC micropulse transscleral cyclophotocoagulation |
| title | Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) |
| title_full | Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) |
| title_fullStr | Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) |
| title_full_unstemmed | Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) |
| title_short | Case report – Acute Corneal Subepithelial Hydrops (ACSH) during Micropulse Transscleral Cyclophotocoagulation (MPTSC) |
| title_sort | case report acute corneal subepithelial hydrops acsh during micropulse transscleral cyclophotocoagulation mptsc |
| topic | ACSH case report Acute corneal subepithelial hydrops MPTSC micropulse transscleral cyclophotocoagulation |
| url | http://link.springer.com/article/10.1186/s12886-020-01669-6 |
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