A Novel Procedure for the Management of Severe Hyphema after Glaucoma Filtering Surgery: Air-Blood Exchange under a Slit-Lamp Biomicroscopy.

I-Hung Lin,Yi-Hao Chen,Chang-Min Liang,Da-Wen Lu,Lung-Chi Lee,Ke-Hao Huang

doi:10.3390/medicina57080855

I-Hung Lin, Yi-Hao Chen + Show 4 more

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https://doi.org/10.3390/medicina57080855

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Abstract

Background and Objectives: This study introduces a novel office-based procedure involving air–blood exchange under a slit-lamp microscope for treatment of severe hyphema after filtering surgery. Materials and Methods: This retrospective study enrolled 17 patients (17 eyes) with a diagnosis of primary open-angle glaucoma with severe hyphema (≥4-mm height) after filtering surgery. All patients were treated with air–blood exchange under a slit-lamp using room air (12 patients) or 12% perfluoropropane (C3F8; five patients). Results: The procedures were successful in all 17 patients; they exhibited clear visual axes without complications during follow-up. In the room air group, the mean visual acuity (VA) and hyphema height significantly improved from 1.70 ± 1.07 LogMAR and 5.75 ± 1.14 mm before the procedure to 0.67 ± 0.18 LogMAR and 2.83 ± 0.54 mm after the procedure (p = 0.004; p < 0.001). In the C3F8 group, the mean VA showed a trend, though not significant, for improvement from 1.70 ± 1.10 LogMAR to 0.70 ± 0.19 LogMAR (p = 0.08); the mean hyphema height showed a trend for improvement from 5.40 ± 0.96 mm to 3.30 ± 0.45 mm. Compared with the C3F8 group, the room air group showed the same efficacy with a shorter VA recovery time. Conclusions: “Air–blood exchange under a slit-lamp using room air” is a convenient, rapid, inexpensive, and effective treatment option for severe hyphema after filtering surgery, and may reduce the risk of failure of filtering surgery.

Highlights

Hyphema is defined as the accumulation of red blood cells in the anterior chamber of the eye; the blood must be grossly visible, either on direct inspection or via slit-lamp examination [1]
We introduce a agovernment novel ambulatory procedure for the treatment severe hyphema after filtering surgery, novel ambulatory procedure for the treatment of severe hyphema filteringmay surgery, that involves air–blood exchange under a slit-lamp microscope
Was used for five who who exhibited an obstruction of the visual axis because of severe hyphema after filtering exhibited an obstruction of the visual axis because of severe hyphema after filtering surgery surgery on postoperative dayobservation

Summary

Introduction

Hyphema is defined as the accumulation of red blood cells in the anterior chamber of the eye; the blood must be grossly visible, either on direct inspection or via slit-lamp examination [1]. This blood accumulation is a result of the disruption of the vessels at the root of the iris or anterior face of the ciliary body, typically due to trauma, underlying medical conditions, or surgical complications [2]. In. This study introduces a novel office-based procedure involving air–blood exchange under a slit-lamp microscope for treatment of severe hyphema after filtering surgery.

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