Abstract
Patients with spontaneous lens dislocation and glaucoma can be challenging to manage. We present a forty-six year old Caucasian lady who was referred with bilateral high intraocular pressure, and was subsequently diagnosed with glaucoma in association with lens dislocation and Marfan syndrome. Baerveldt glaucoma drainage device tubes were inserted in both eyes due to poor response to medical therapy. However, this was complicated by recurrent vitreous occlusion of both glaucoma drainage tubes requiring further multiple surgical interventions. There have not been any further recurrences of vitreous incarceration or posterior segment complications since, but the patient remains under close follow-up.
Highlights
Patients with spontaneous lens dislocation and glaucoma can be challenging to manage
Case presentation A 46-year old Caucasian female was originally referred to the Eye Casualty department by the community optometrist because of bilateral raised intraocular pressures (IOPs) in the thirties
Several retrospective studies have found combined pars plana vitrectomy (PPV) with glaucoma drainage device (GDD) implantation to be successful in controlling IOP in refractory glaucoma, including patients with aphakic glaucoma [7,8,9]
Summary
Our case report illustrates the difficulties and challenges that can arise when managing a Marfan syndrome patient with lens dislocation and glaucoma. Colour photograph of the left eye one week following her second anterior vitrectomy (via the pars plana) - the Baerveldt implant tube looked patent, the pupil was round and there was no vitreous in the anterior chamber
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