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Ophthalmology and Visual Sciences

Hyphema following aborted iStent procedure

Hyphema following aborted iStent procedure

Category(ies): Cataract, Glaucoma
Contributor: Austin R. Fox, MD, and Michael Griess, MD
Photographer: Moneeb Akhtar, BS

contracting post-operative hyphema two weeks after an iStent
External photograph of the left eye shows a contracting post-operative hyphema two weeks after an iStent® trabecular micro-bypass procedure. The surgery had been aborted due to development of a hyphema and poor view. A hyphema is a rare complication during iStent insertion but has been reported in several publications [1-7]. However, microhyphemas observed on gonioscopy after the iStent procedure are more commonly seen.
References:
  1. Samuelson TW, Katz LJ, Wells JM, Duh YJ, Giamporcaro JE; US iStent Study Group. Randomized evaluation of the trabecular micro-bypass stent with phacoemulsification in patients with glaucoma and cataract. Ophthalmology. 2011;118(3):459-67.
  2. Patel I, de Klerk TA, Au L. Manchester iStent study: early results from a prospective UK case series. Clin Exp Ophthalmol. 2013;41(7):648-52.
  3. Sandhu S, Arora S, Edwards MC. A case of delayed-onset recurrent hyphema after iStent surgery. Can J Ophthalmol. 2016;51(6):e165-e167.
  4. Buchacra O., Duch S., Milla E., and Stirbu O.: One-year analysis of the iStent trabecular microbypass in secondary glaucoma. Clin Ophthalmol 2011; 5: pp. 321-326
  5. Donnenfeld ED, Solomon KD, Voskanyan L, Chang DF, Samuelson TW, Ahmed II, Katz LJ. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma. Clin Ophthalmol. 2015;9:2057-65.
  6. Khouri AS, Megalla MM. Recurrent hyphema following iStent surgery managed by surgical removal. Can J Ophthalmol. 2016;51(6):e163-e165.
  7. Shiba D, Hosoda S, Yaguchi S, Ozeki N, Yuki K, Tsubota K. Safety and Efficacy of Two Trabecular Micro-Bypass Stents as the Sole Procedure in Japanese Patients with Medically Uncontrolled Primary Open-Angle Glaucoma: A Pilot Case Series. J Ophthalmol. 2017;2017:9605461.

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