Abstract
BackgroundTo describe, a yet non-documented complication of GDI surgery (glaucoma drainage incision surgery) - anterior to posterior segment migration of Ahmed Glaucoma Valve (AGV) tube.Case PresentationWe report a young 9 year old boy, diagnosed with refractory glaucoma with Reiger anomaly. History included of poor vision in both eyes, left more than right with glare since childhood. He underwent GDI surgery with AGV implantation following which he developed posterior migration of AGV tube. The detailed ocular history, ophthalmic findings, clinical course, surgical management and development of the posterior tube migration is discussed.ConclusionPosterior Migration of AGV tube has yet not been described. Also there is a role of expectant management of the complication in this case as evidenced by the benign course of events.
Highlights
To describe, a yet non-documented complication of GDI surgery - anterior to posterior segment migration of Ahmed Glaucoma Valve (AGV) tube.Case Presentation: We report a young 9 year old boy, diagnosed with refractory glaucoma with Reiger anomaly
A syndromal mesodermal dysgenesis of the cornea and iris was described in mid 30’s by Reiger [1]
The patient, who presented to us, had a similar bilateral presentation, with varying iris and corneal changes in absence of systemic developmental defects classifying him as a case of Reiger anomaly
Summary
Rieger’s anomaly [1] is characterized by a dysgenesis of the anterior ocular segment with peripheral iris strands, an abnormally prominent Schwalbe’s line, and a stromal atrophy of the iris. Case Presentation A 9 year old child presented to the out patient services of our eye department with chief complaints of gradual, progressive loss of vision in both eyes, left more than right, over a period of two years.The patient had primary complaint of intolerance to bright light, in the right eye. The intraocular pressures fell to early thirties but continued to be raised For such a refractory glaucoma in a young unilaterally blind child, line of management was selected to be incision surgery with aqueous shunt (AGV) implantation for the right eye and a cyclodestructive procedure for the painful blind left eye. Rest of the features remained unaltered with normal intraocular pressures and no evidence of cataract At his current status, 12 months after surgery and 6 months after the first evidence of tube migration, the patient maintains lens transparency and normal IOP.
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