J Korean Ophthalmol Soc.  2009 Apr;50(4):635-639. 10.3341/jkos.2009.50.4.635.

Delayed Suprachoroidal Hemorrhage After Ahmed Valve Implantation for Neovascular Glaucoma

• Koh T
• Jung JY
• Shim HS
• Kim HK

• KMID: 2212268
• DOI: http://doi.org/10.3341/jkos.2009.50.4.635

Abstract

PURPOSE
To report the case of delayed suprachoroidal hemorrhage after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. CASE SUMMARY: A 74-years-old male visited the hospital with ocular pain in the left eye. He had a history of vitrectomy and Intraocular lens (IOL) scleral fixation due to trauma in the left eye. NVG was diagnosed and Ahmed valve was implanted in his left eye. Three days later, hypotony occurred with all quadrant choroidal detachment. Next day, raised intraocular pressure (IOP) was checked and anterior chamber was flat on slit lamp examination. Vitreous hemorrhage and suprachoroidal hemorrhage were suspected. We performed anterior chamber formation with viscoelastics. The anterior chamber became deeper and hemorrhage gradually decreased. A month later, the patient visited us with severe ocular pain. Raised IOP and shallow anterior chamber due to moderate hyphema and anteriorly placed IOL were found. Retinal detachment was suspected on B-scan. Vitrectomy, IOL removal, silicone oil insertion, and Ahmed valve removal were performed. CONCLUSIONS: We report we experienced one patient of delayed suprachoroidal hemorrhage after Ahmed valve implantation and he had poor prognosis.

Keyword

Ahmed valve; Choroidal detachment; Suprachoroidal hemorrhage

MeSH Terms

Anterior Chamber
Choroid
Eye
Glaucoma, Neovascular
Hemorrhage
Humans
Hyphema
Intraocular Pressure
Lenses, Intraocular
Male
Prognosis
Retinal Detachment
Silicone Oils
Vitrectomy
Vitreous Hemorrhage
Silicone Oils

Figure

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  Figure 1. On preoperative B-scan, vitreous and retina showed normal findings.

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  Figure 2. Five days after Ahmed valve implantation, B-scan showed large amount of vitreous and suprachoroidal hemorrhage.

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  Figure 3. After anterior chamber formation, anterior chamber became deep and Ahmed valve tip was in placed (A). On B-scan, vitreous and suprachoroidal hemorrhage decreased gradually (B).

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  Figure 4. On follw-up examination after chamber formation, IOP was well controlled and anterior segment photograph showed continuously deep anterior chamber.

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  Figure 5. One month after Ahmed valve implantation, suddenly patient complained ocular pain and headache with high IOP. Funnel shape of retinal detachment was suspicious on B-scan.

Reference

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