Occult wound leak diagnosed by ultrasound biomicroscopy in patients with postoperative hypotony

Journal of Cataract and Refractive Surgery
G W Sicco thoe Schwartzenberg, Charles J Pavlin

Abstract

To describe the ability of high-frequency ultrasound biomicroscopy (UBM) to diagnose occult wound leaks as a cause for hypotony after cataract surgery. Six patients with persistent hypotony after cataract surgery were sent for UBM examination. Slitlamp examination and gonioscopy of the 6 eyes had not revealed a cause for the hypotony. Ultrasound biomicroscopy showed subtle wound separation with shallow conjunctival elevation at the site of the cataract wound in the 6 patients. Two eyes had surgical repair of the subconjunctival wound leak, and the other 4 were treated medically. In the 2 eyes with surgically repaired wounds, the hypotony cleared after wound closure. Of the 4 medically treated eyes, hypotony resolved in 2 and 1 had a recurrence of hypotony. The other 2 eyes had fluctuating intraocular pressure for an extended period. Hypotony after cataract surgery occurred in 6 eyes due to subtle wound leaks difficult to detect by clinical observation. Ultrasound biomicroscopy can be a helpful aid to clinical examination in detecting these leaks.

References

Mar 1, 1991·Ophthalmology·C J PavlinF S Foster
Apr 15, 1994·American Journal of Ophthalmology·W S Karwatowski, R N Weinreb

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Citations

Feb 26, 2013·Journal of Cataract and Refractive Surgery·Samuel MasketNicole Fram
Jan 14, 2009·Clinical & Experimental Ophthalmology·Ronald H Silverman
Jun 28, 2016·American Journal of Ophthalmology·Ahmadreza MoradiJennifer E Thorne

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